Evidence map›Paper›PMID 39747577›Full record

ArticleScientific reports2025

Impact of epinephrine on neurological outcomes in out-of-hospital cardiac arrest after automated external defibrillator use in Japan.

Atsushi Kubo, Atsushi Hiraide, Tomohiro Shinozaki, Naoaki Shibata, Kyohei Miyamoto, Shinobu Tamura, Shigeaki Inoue

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2025. 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
–field-weighted citation impact
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.

  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

7 authors.

Atsushi KuboDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan.
Atsushi HiraideFaculty of Emergency Medical Science, Meiji University of Integrative Medicine, Kyoto, Japan.
Tomohiro ShinozakiDepartment of Information and Computer Technology, Tokyo University of Science, Tokyo, Japan.
Naoaki ShibataDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan.
Kyohei MiyamotoDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan.
Shinobu TamuraDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan. stamura@wakayama-med.ac.jp.
Shigeaki InoueDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan.

Funding

JSPS KAKENHI 23K07865Wakayama Medical University Special Grant-in-Aid for Research Projects K23TS03
6 · The paper itself

Abstract

OHCA (out-of-hospital cardiac arrest) patients have improved neurological outcomes with public-access automated external defibrillator (PAD) use. However, the benefit of epinephrine administration after PAD use remains controversial. The purpose of the study was to investigate the impact of epinephrine administration on neurological outcomes in OHCA patients after PAD use. This study assessed 2,059,417 patients from the All-Japan Utstein Registry between 2005 and 2021. Patients were categorized into two groups: shockable and non-shockable rhythms on emergency medical service (EMS) arrival. Propensity score matching was used to adjust for various confounders and to analyze the impact of epinephrine administration on one-month favorable neurological outcomes. Criteria for bystander PAD was met by 11,629 (0.56%) of the enrolled patients. The mean age was 70 years with 71.9% male. Among them, 38.6% had shockable rhythms and 61.4% had non-shockable rhythms. After the matching, epinephrine administration negatively affected one-month favorable neurological outcome in patients with both shockable (14.7% vs. 41.1%, OR = 0.24, 95% CI = 0.19-0.31) and non-shockable rhythms (3.6% vs. 10.8%, OR = 0.31, 95% CI = 0.23-0.42). These findings suggest that epinephrine administration did not improve neurological outcomes in patients with OHCA after PAD use, providing insights to optimize EMS protocols for OHCA.

Indexed as

DefibrillatorsEmergency Medical ServicesEpinephrineOut-of-Hospital Cardiac ArrestAgedAged, 80 and overCardiopulmonary ResuscitationElectric CountershockFemaleHumansJapanMaleMiddle AgedPropensity ScoreRegistriesTreatment OutcomeEpinephrineBystanderCardiopulmonary resuscitationEpinephrineFavorable neurological outcomeOut-of-hospital cardiac arrestPublic-access automated external defibrillator

Identifiers

PMID39747577
PMCPMC11696545

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LicenceCC BY-NC-ND
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Registered trials

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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.