ArticleResuscitation plus2021
Seizure-like activity at the onset of emergency medical service-witnessed out-of-hospital cardiac arrest: An observational study.
Article in Resuscitation plus, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- 2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 2. Current status of cardiac arrest and the chain of survival.Clinical and experimental emergency medicine · 2026Guideline
- Predicting Critical Outcomes in Suspected Cardiopulmonary Emergencies Using Dispatch Narratives: Temporal Validation Study.Journal of medical Internet research · 2026Article
- Point-of-Care EEG Artificial Intelligence Measure of Seizure Burden Associates With Clinical Outcome at Discharge.Critical care medicine · 2026Article
- Characteristics and causes in patients presenting with convulsions in the Danish prehospital setting.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Pulseless Electrical Activity Arrest Presenting as Tonic Arm Stiffening and a Flat Electroencephalogram.The Neurohospitalist · 2024Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsEmergency medical service (EMS) may detect seizure-like activity in addition to agonal breathing in out-of-hospital cardiac arrest (OHCA). This study investigates the incidence and predictors of seizure-like activity in nontraumatic, EMS-witnessed OHCA and their association with clinical outcomes.
methodsThis prospective study explored EMS-recorded concomitant signs/symptoms that lead to the requirement of advanced life support in patients with nontraumatic, EMS-witnessed OHCA. Seizure-like activity includes abnormal/tonic movements and eyeball deviation. Sudden OHCA was defined by the absence of signs/symptoms of impending cardiac arrest at EMS contact or progressive circulatory/respiratory depressions after the EMS contact. Neurologically favorable outcomes were defined as the cerebral performance category score of 1 or 2 at discharge.
resultsFrom April 2012 to March 2020, 465 patients were studied. The incidence of seizure-like activity at cardiac arrest onset was 12.7% (59/465) in all patients with nontraumatic, EMS-witnessed OHCA. Seizure-like activity was common during shockable initial rhythm; in patients with "sudden" OHCA; and in patients who were younger, male, or had a presumed cardiac etiology. In a boosting tree, shockable initial rhythm, "sudden" OHCA, and presumed cardiac etiology were major factors that predicted the incidence of seizure-like activity. Multivariate logistic regression models including and excluding OHCA characteristics revealed that both seizure-like activity and agonal breathing recorded during EMS-witnessed OHCA were associated with favorable outcomes.
conclusionsSeizure-like activity is a major sign/symptom of the onset of "sudden" cardiac arrest of presumed cardiac etiology, particularly in patients with shockable initial rhythms. Such activity were significantly associated with neurologically favorable outcomes.
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