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- 저자 : Korean Cardiac Arrest Research Consortium (KoCARC) Investigators (검색결과 1 건)
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한은아,공태영,유제성,박인철,박고은,이수지,정성필,Korean Cardiac Arrest Research Consortium (KoCARC) Investigators 연세대학교의과대학 2022 Yonsei medical journal Vol.63 No.2
Purpose: A pilot project using epinephrine at the scene under medical control is currently underway in Korea. This study aimedto determine whether prehospital epinephrine administration is associated with improved survival and neurological outcomesin out-of-hospital cardiac arrest (OHCA) patients who received epinephrine during cardiopulmonary resuscitation (CPR) in theemergency department. Materials and Methods: This retrospective observational study used a nationwide multicenter OHCA registry. Patients were classifiedinto two groups according to whether they received epinephrine at the scene or not. The associations between prehospitalepinephrine use and outcomes were assessed using propensity score (PS)-matched analysis. Multivariable logistic regression analysiswas performed using PS matching. The same analysis was repeated for the subgroup of patients with non-shockable rhythm. Results: PS matching was performed for 1084 patients in each group. Survival to discharge was significantly decreased in the patientswho received prehospital epinephrine [odds ratio (OR) 0.415, 95% confidence interval (CI) 0.250–0.670, p<0.001]. However,no statistical significance was observed for good neurological outcome (OR 0.548, 95% CI 0.258–1.123, p=0.105). For the patientsubgroup with non-shockable rhythm, prehospital epinephrine was also associated with lower survival to discharge (OR 0.514, 95%CI 0.306–0.844, p=0.010), but not with neurological outcome (OR 0.709, 95% CI 0.323–1.529, p=0.382). Conclusion: Prehospital epinephrine administration was associated with decreased survival rates in OHCA patients but not statisticallyassociated with neurological outcome in this PS-matched analysis. Further research is required to investigate the reasonfor the detrimental effect of epinephrine administered at the scene.
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