Acute cardiac care & resuscitation
Regional implementation of a prehospital advanced life support program with video-assisted physician direction and outcomes after out-of-hospital cardiac arrest
Main finding · Prehospital time intervalResult — go to the resultDifference-in-differences 4.12 minutes 95% CI 2.91–5.33Authors' conclusion
SALS regions showed greater increases in prehospital time and prehospital ROSC without significant improvements in survival to discharge or favorable neurological outcome, but the finding for prehospital time should be interpreted cautiously because differential pre-intervention trends were observed.
Study context
- Population
- Adult out-of-hospital cardiac arrest (OHCA) cases (aged ≥19 years) in the OHCA surveillance system in South Korea, from 2 years before through 4 years after smart advanced life support (SALS) implementation in August 2015cases included
- Participants
- 129,207 cases
- Exposure
- Pre- to post-implementation changes were compared between regions with and without SALS.
- Outcome
- Prehospital time interval
Methodological detailsdifference-in-differences and event-study analyses
- Difference-in-differences and event-study analyses
Main finding
As reported in the abstract
Difference-in-differences
4.12 minutes
95% CI 2.91–5.33
SALS regions vs regions without SALS
difference-in-differences 4.12 minutes (95% CI 2.91–5.33)
Observational data: associations, not effects.
Further findings
| Outcome | Difference-in-differences (percentage points) (95% CI) | |
|---|---|---|
| Prehospital ROSCGreater increase in SALS regions | 1.35 (0.56–2.15) | |
| Survival to dischargeNo significant additional improvement | −0.35 (−1.31 to 0.62) | |
| Favorable neurological outcomeNo significant additional improvement | −0.35 (−1.08 to 0.37) | |
| −2−10123Difference, percentage points (linear scale) |
Pre-intervention trends (event-study analyses)
- Differential pre-intervention trends for prehospital time, but not for the other outcomes
Original publication
Regional implementation of a prehospital advanced life support program with video-assisted physician direction and outcomes after out-of-hospital cardiac arrest. Resuscitation. Published 20 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it