TY - JOUR
T1 - Acute hospital administration of amiodarone and/or lidocaine in shockable patients presenting with out-of-hospital cardiac arrest
T2 - A nationwide cohort study
AU - Huang, Chien Hua
AU - Yu, Ping Hsun
AU - Tsai, Min Shan
AU - Chuang, Po Ya
AU - Wang, Tzung Dau
AU - Chiang, Chih Yen
AU - Chang, Wei Tien
AU - Ma, Matthew Huei Ming
AU - Tang, Chao Hsiun
AU - Chen, Wen Jone
N1 - Publisher Copyright:
© 2016
PY - 2017/1/15
Y1 - 2017/1/15
N2 - Background Terminating ventricular fibrillation (VF) or pulseless ventricular tachyarrhythmia (VT) is critical for successful resuscitation of patients with shockable cardiac arrest. In the event of shock-refractory VF, applicable guidelines suggest use of anti-arrhythmic agents. However, subsequent long-term outcomes remain unclear. A nationwide cohort study was therefore launched, examining 1-year survival rates in patients given amiodarone and/or lidocaine for cardiac arrest. Methods Medical records accruing between years 2004 and 2011 were retrieved from the Taiwan National Health Insurance Research Database (NHIRD) for review. This repository houses all insurance claims data for nearly the entire populace (> 99%). Candidates for study included all non-traumatized adults receiving DC shock and cardiopulmonary resuscitation immediately or within 6 h of emergency room arrival. Analysis was based on data from emergency rooms and hospitalization. Results One-year survival rates by treatment group were 8.27% (534/6459) for amiodarone, 7.15% (77/1077) for lidocaine, 11.10% (165/1487) for combined amiodarone/lidocaine use, and 3.26% (602/18,440) for use of neither amiodarone nor lidocaine (all, p < 0.0001). Relative to those given neither medication, odds ratios for 1-year survival via multiple regression analysis were 1.84 (95% CI: 1.58–2.13; p < 0.0001) for amiodarone, 1.88 (95% CI: 1.40–2.53; p < 0.0001) for lidocaine, and 2.18 (95% CI: 1.71–2.77; p < 0.0001) for dual agent use. Conclusions In patients with shockable cardiac arrest, 1-year survival rates were improved with association of using amiodarone and/or lidocaine, as opposed to non-treatment. However, outcomes of patients given one or both medications did not differ significantly in intergroup comparisons.
AB - Background Terminating ventricular fibrillation (VF) or pulseless ventricular tachyarrhythmia (VT) is critical for successful resuscitation of patients with shockable cardiac arrest. In the event of shock-refractory VF, applicable guidelines suggest use of anti-arrhythmic agents. However, subsequent long-term outcomes remain unclear. A nationwide cohort study was therefore launched, examining 1-year survival rates in patients given amiodarone and/or lidocaine for cardiac arrest. Methods Medical records accruing between years 2004 and 2011 were retrieved from the Taiwan National Health Insurance Research Database (NHIRD) for review. This repository houses all insurance claims data for nearly the entire populace (> 99%). Candidates for study included all non-traumatized adults receiving DC shock and cardiopulmonary resuscitation immediately or within 6 h of emergency room arrival. Analysis was based on data from emergency rooms and hospitalization. Results One-year survival rates by treatment group were 8.27% (534/6459) for amiodarone, 7.15% (77/1077) for lidocaine, 11.10% (165/1487) for combined amiodarone/lidocaine use, and 3.26% (602/18,440) for use of neither amiodarone nor lidocaine (all, p < 0.0001). Relative to those given neither medication, odds ratios for 1-year survival via multiple regression analysis were 1.84 (95% CI: 1.58–2.13; p < 0.0001) for amiodarone, 1.88 (95% CI: 1.40–2.53; p < 0.0001) for lidocaine, and 2.18 (95% CI: 1.71–2.77; p < 0.0001) for dual agent use. Conclusions In patients with shockable cardiac arrest, 1-year survival rates were improved with association of using amiodarone and/or lidocaine, as opposed to non-treatment. However, outcomes of patients given one or both medications did not differ significantly in intergroup comparisons.
KW - 1-Year survival
KW - Amiodarone
KW - Lidocaine
KW - Out-of-hospital cardiac arrest
KW - Shockable rhythm
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U2 - 10.1016/j.ijcard.2016.11.101
DO - 10.1016/j.ijcard.2016.11.101
M3 - Article
C2 - 27843049
AN - SCOPUS:85004011429
SN - 0167-5273
VL - 227
SP - 292
EP - 298
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -