Acute cardiac care & resuscitation
Pulseless electrical activity and asystole during in-hospital cardiac arrest: Disentangling the ‘nonshockable’ rhythms
Main finding · ROSCResult — go to the resultAdjusted odds ratio 0.97 95% CI 0.96–0.97Authors' conclusion
Patients suffering IHCA with an initial PEA rhythm had patient and resuscitation level differences from those with asystole. PEA arrests were more common in monitored settings and received longer resuscitations. Even though PEA was associated with higher rates of ROSC, there was no difference in survival to discharge.
Study context
- Population
- Adults with index in-hospital cardiac arrest and initial rhythm of pulseless electrical activity (PEA) or asystole, 2006–2019
- Participants
- 147,377 vs 79,720
- Exposure
- PEA vs asystole as initial in-hospital cardiac arrest (IHCA) rhythm
- PEAn = 147,377reference
- Asystolen = 79,720
- Outcome
- ROSC
Methodological detailsprospectively collected nationwide registry (Get With The Guidelines-Resuscitation)
- Prospectively collected nationwide registry (Get With The Guidelines-Resuscitation)
Main finding
As reported in the abstract
Adjusted odds ratio
0.97
95% CI 0.96–0.97
P < 0.01
Events by group
Asystole vs PEA
aOR 0.97 (95% CI 0.96–0.97); P < 0.01
Observational data: associations, not effects.
Further findings
| Outcome | PEA | Asystole | aOR (95% CI) | P value | |
|---|---|---|---|---|---|
| Survival to discharge | 19.1% | 18.7% | 1.00 (1.00–1.01) | P = 0.63 | |
| 0.512Adjusted odds ratio (log scale) |
| Outcome | PEA | Asystole | Adjusted mean difference (95% CI) | P value | |
|---|---|---|---|---|---|
| Duration of resuscitation (without ROSC) | 29.8 ± 22.5 minutes | 26.2 ± 21.5 minutes | −3.05 (−3.36--2.74) | P < 0.01 | |
| −4−202Difference (linear scale) |
Arrest in non-telemetry ward
Original publication
Pulseless electrical activity and asystole during in-hospital cardiac arrest: Disentangling the ‘nonshockable’ rhythms. Resuscitation. Published 1 June 2023. doi:10.
Summarised from the published abstract; every number is checked against it