Association Between Time to Defibrillation and Neurologic Outcome in Patients With In-Hospital Cardiac Arrest.

BACKGROUND

The influence of time to defibrillation in patients with shockable in-hospital cardiac arrest (IHCA) has not been fully assessed. This study investigated the association between time to defibrillation and neurologic outcome in shockable IHCA survivors.

MATERIALS AND

METHODS

A 7-year retrospective cohort study was conducted using a prospectively collected registry of adult IHCA patients. Patients whose first documented rhythm was pulseless ventricular tachycardia or ventricular fibrillation and who received defibrillation within 5 minutes were included.

RESULTS

Among 1,683 IHCA patients, 261 patients were included. At 28 days, a good neurologic outcome (Cerebral Performance Category score 1 or 2) according to time to defibrillation was seen in 49.0%, 21.1%, 13.4% and 16.5% of patients treated at <2 minutes (n = 128), 2-3 minutes (n = 55), 3-4 minutes (n = 35) and 4-5 minutes (n = 43) after IHCA, respectively. After adjusting for clinical characteristics, a graded inverse association was found after 3 minutes.

CONCLUSIONS

A graded inverse association between time to defibrillation and neurologic outcome was observed beyond 3 minutes following cardiac arrest. A target time to defibrillation of <3 minutes may be a practical target goal in resource-limited hospitals.