Association Between Timing of Epinephrine Administration and Outcomes of Traumatic Out-of-Hospital Cardiac Arrest Following Traffic Collisions

Overview

Journal J Clin Med

Specialty General Medicine

Date 2022 Jun 24

PMID 35743634

Authors

Sanae Hosomi

Tetsuhisa Kitamura

Tomotaka Sobue

Ling Zha

Kosuke Kiyohara

Tasuku Matsuyama

Jun Oda

Affiliations

Soon will be listed here.

Abstract

The effects of epinephrine administration timing on patients with out-of-hospital cardiac arrest (OHCA) following traffic collisions are unknown. We analyzed the 2013-2019 All-Japan Utstein Registry data of 2024 such patients aged ≥18 years who were resuscitated by emergency medical service (EMS) personnel or bystanders and then transported to medical institutions. Time from 119 call to epinephrine administration was classified into quartiles: Q1 (6-21 min), Q2 (22-26 min), Q3 (27-34 min), and Q4 (35-60 min). Multivariable logistic regression analysis was used to assess the effects of epinephrine administration timing on one-month survival after OHCA. Overall, the one-month survival rates were 3.2% (15/466) in Q1, 1.1% (5/472) in Q2, 1.9% (11/577) in Q3, and 0.2% (1/509) in Q4. Additionally, the one-month survival rate decreased significantly in the Q4 group (adjusted odds ratio, 0.07; 95% confidence interval, 0.01-0.57) compared with the Q1 group, and the probability of one-month survival decreased as the time from the EMS call to epinephrine administration increased (-value for trend = 0.009). Only four patients (0.9% [4/466]) with the earliest epinephrine administration showed a good neurological outcome.

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