Evidence map›Paper›PMID 33454143›Full record

ArticleThe Journal of emergency medicine2021

Changes in Field Termination of Resuscitation and Survival Rates After an Educational Intervention to Promote on Scene Resuscitation for Out-of-Hospital Cardiac Arrest.

Brian M Clemency, Johanna C Innes, Michael Waldrop, Lynn J White, Eric Dievendorf, Robert Orlowski, Kejia Wang, Heather A Lindstrom, John M Canty, David Hostler

Open access · greenAbstract read
In one paragraph

Article in The Journal of emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Brian M ClemencyDepartment of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York; Global Medical Response, Greenwood Village, Colorado; Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York.
Johanna C InnesDepartment of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York; Global Medical Response, Greenwood Village, Colorado.
Michael WaldropDepartment of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York.
Lynn J WhiteGlobal Medical Response, Greenwood Village, Colorado.
Eric DievendorfGlobal Medical Response, Greenwood Village, Colorado.
Robert OrlowskiGlobal Medical Response, Greenwood Village, Colorado.
Kejia WangDepartment of Biostatistics, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York.
Heather A LindstromDepartment of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York.
John M CantyDepartment of Medicine, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York.
David HostlerDepartment of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York; Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York.
Jacobs Institute · USUniversity at Buffalo, State University of New York · US

Funding

University of Buffalo Clinical and Translational Science Institute - Supplement SchulyerUL1TR001412 · NCATS · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI MURPHY, TIMOTHY F · 2015 to 2024
$33.8M
PAREPET II_Prediction of ARrhythnic Events with Positron Emission Tomography IIR01HL130266 · NHLBI · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI CANTY, JOHN M, FALLAVOLLITA, JAMES · 2016 to 2022
$3.6M
UB Clinical Scholar Program in Implementation Science to Achieve Triple AimsK12HL138052 · NHLBI · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI CANTY, JOHN M, SINGH, RANJIT · 2017 to 2021
$3.1M
Preventing and Reversing Interstitial Fibrosis in HFpEFI01BX002659 · VA · VA WESTERN NEW YORK HEALTHCARE SYSTEM · PI Brian Raymond Weil · 2016 to 2026
–
BLRD VA I01 BX002659NCATS NIH HHS UL1 TR001412NHLBI NIH HHS K12 HL138052NHLBI NIH HHS R01 HL130266
6 · The paper itself

Abstract

backgroundEmergency medical services (EMS) agencies with higher field termination-of-resuscitation (TOR) rates tend to have higher survival rates from out-of-hospital cardiac arrest (OHCA). Whether EMS agencies can improve survival rates through efforts to focus on resuscitation on scene and optimize TOR rates is unknown.

objectiveThe goal of this study was to determine if an EMS agency's efforts to enhance on-scene resuscitation were associated with increased TOR and OHCA survival with favorable neurologic outcome.

methodsA single-city, retrospective analysis of prospectively collected 2017 quality assurance data was conducted. Patient demographics, process, and outcome measures were compared before and after an educational intervention to increase field TOR. The primary outcome measure was survival to hospital discharge with favorable neurologic status.

resultsThere were 320 cases that met inclusion criteria. No differences in age, gender, location, witnessed arrest, bystander cardiopulmonary resuscitation, initial shockable rhythm, or presumed cardiac etiology were found. After the intervention, overall TOR rate increased from 39.6% to 51.1% (p = 0.06). Among subjects transported without return of spontaneous circulation (ROSC), average time on scene increased from 26.4 to 34.2 min (p = 0.02). Rates of sustained ROSC and survival to hospital admission were similar between periods. After intervention, there was a trend toward increased survival to hospital discharge rate (relative risk [RR] 2.09; 95% confidence interval [CI] 0.74-5.91) and an increase in survival with favorable neurologic status rate (RR 5.96; 95% CI 0.80-44.47).

conclusionThis study described the association between an educational intervention focusing on optimization of resuscitation on scene and OHCA process and outcome measures. Field termination has the potential to serve as a surrogate marker for aggressively treating OHCA patients on scene.

Indexed as

Cardiopulmonary ResuscitationEmergency Medical ServicesOut-of-Hospital Cardiac ArrestHumansRetrospective StudiesSurvival Rateemergency medical servicesheart arrestout-of-hospital heart arrest

Identifiers

PMID33454143
PMCPMC8672378
OpenAlexW3119505980

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.