ArticleResuscitation plus2025
Factors for good neurological outcome in adult OHCA with initial shockable rhythm: a retrospective multicenter cohort study from the German Resuscitation Registry.
Article in Resuscitation plus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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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
2 citing papers in PubMed.
- Helicopter vs. ground transport: outcomes of out-of-hospital cardiac arrest patients with intra-arrest transport.Wiener klinische Wochenschrift · 2026Article
- Effect of higher currents on defibrillation success in out-of-hospital cardiac arrest: a multicentre cohort analysis.Resuscitation plus · 2026Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Study aim: This study examined defibrillation attempts during out-of-hospital cardiac arrest (OHCA) with shockable rhythm and survival outcomes, focusing on good neurological outcome at discharge. It aimed to identify predictors of favorable outcomes and guide future trials for alternative defibrillation strategies. Methods: In this retrospective, multicenter cohort study, data were extracted from the German Resuscitation Registry for adult patients (≥18 years) who experienced OHCA with an initial shockable rhythm between January 2007 and December 2023. Only cases from good data quality centers were included. Patients were categorized according to the number of defibrillations received (1, 2-3, 4-6, and ≥7). Multivariable logistic regression was performed to identify independent predictors of favorable neurological outcomes. Results: Out of 332,001 OHCA records, 15,284 met the inclusion criteria. Survival endpoints, including any return of spontaneous circulation, hospital admission with ROSC, 24-h survival, and survival to discharge, significantly declined with an increasing number of defibrillation attempts. In the regression analysis, EMS-witnessed arrests were strongly associated with favorable outcomes (OR 3.8; 95 % Confidence Interval 3.1-4.7). More defibrillations, prolonged ambulance response times, and older age were independently associated with lower odds of achieving a favorable neurological outcome. Conclusion: An increasing number of defibrillations is independently linked to reduced survival and worse neurological outcomes in adults experiencing out-of-hospital cardiac arrest with an initial shockable rhythm. These results underscore the urgent need for alternative management strategies for multiple defibrillation attempts. These compelling observations warrant a reevaluation of defibrillation protocols to improve patient outcomes.
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