Abstract 16472: Advanced vs. Basic Life Support in the Treatment of Out-of-Hospital Cardiopulmonary Arrest in the Resuscitation Outcomes Consortium
Objective: Prior studies using hospital-based insurance claims data suggest higher survival after out-of-hospital cardiac arrest (OHCA) with basic (BLS) than advanced life support (ALS) prehospital care. We sought to compare the association of ALS care upon OHCA outcomes using prospectively collected clinical data from the Resuscitation Outcomes Consortium (ROC).
Methods: Included were consecutive adults with non-traumatic OHCA treated by ROC EMS agencies between June 1, 2011 and June 30, 2015. We defined BLS as receipt of cardiopulmonary resuscitation (CPR) and/or automated defibrillation and ALS as receipt of an advanced airway, manual defibrillation, or intravenous therapy. We compared outcomes among: 1) BLS-only; 2) BLS + early ALS (<6 minutes from BLS arrival); 3) BLS + late ALS (≥6 minutes), and 4) ALS-only. Using multivariable logistic regression, we evaluated the associations between care and return of spontaneous circulation (ROSC), survival to hospital discharge, and survival with good functional status (modified Rankin score, mRs≤3), adjusting for age, sex, witnessed arrest, bystander CPR, shockable initial rhythm, public location, EMS arrival ≤ 6 minutes, CPR fraction, rate, depth, and regional ROC center.
Results: Among 35,065 patients with OHCA, characteristics were median age 68 years (IQR 56-80), male 63.9%, witnessed arrest 43.8%, bystander CPR 50.6%, and shockable initial rhythm 24.2%. Care received was 4.0% BLS-only, 17.2% BLS + early ALS, 31.5% BLS + late ALS, and 47.3% ALS-only. Compared with BLS-only care, ALS care with or without initial BLS care was independently associated with increased adjusted ROSC and hospital survival (table).
Conclusion: ALS care with or without initial BLS care was associated with increased ROSC and hospital survival after OHCA.
Author Disclosures: M.C. Kurz: None. R. Schmicker: None. B. Leroux: None. G. Nichol: None. T. Aufderheide: None. S. Cheskes: None. R. Gray: None. J. Jasti: None. P. Kudenchuk: None. G. Vilke: None. J. Buick: None. L. Wittwer: None. R. Shani: None. A. Brienza: None. R. Straight: None. H.E. Wang: None.
- © 2016 by American Heart Association, Inc.