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Prognostic implications of conversion from nonshockable to shockable rhythms in out-of-hospital cardiac arrest

Overview of attention for article published in Critical Care, September 2014
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Title
Prognostic implications of conversion from nonshockable to shockable rhythms in out-of-hospital cardiac arrest
Published in
Critical Care, September 2014
DOI 10.1186/s13054-014-0528-7
Pubmed ID
Authors

Yoshikazu Goto, Tetsuo Maeda, Yumiko Nakatsu-Goto

Abstract

IntroductionThe prognostic significance of conversion from non-shockable to shockable rhythms in patients with initial non-shockable rhythms who experience out-of-hospital cardiac arrest (OHCA) remains unclear. We hypothesized that the neurological outcomes in those patients would improve with subsequent shock delivery following conversion to shockable rhythms, and that the time from initiation of cardiopulmonary resuscitation by emergency medical services personnel to the first defibrillation (shock delivery time) would influence those outcomes.MethodsWe analyzed the data of 569,937 OHCA adults with initial non-shockable rhythms; the data were collected in a nationwide Utstein-style Japanese database between 2005 and 2010. Patients were divided into subsequently shocked (n¿=¿21,944) and subsequently not-shocked (n¿=¿547,993) cohorts. The primary study end point was 1-month favorable neurological outcome (cerebral performance category scale, category 1 or 2).ResultsIn the subsequently shocked cohort, the ratio of 1-month favorable neurological outcome was significantly higher than that in the subsequently not-shocked cohort (1.79% versus 0.60%, P <0.001). Multivariate logistic regression analysis for 11 prehospital variables revealed that when the shock delivery time was less than 20 minutes, subsequent shock delivery was significantly associated with increased odds of 1-month favorable neurological outcomes (adjusted odds ratio (95% confidence interval), 6.55 (5.21 to 8.22) and 2.97 (2.58 to 3.43); for shock delivery times less than 10 minutes and 10 to 19 minutes, respectively). However, when the shock delivery time was more than or equal to 20 minutes, subsequent shock delivery was not associated with increased odds of 1-month favorable neurological outcomes.ConclusionsIn patients with an initial non-shockable rhythm after OHCA, subsequent conversion to shockable rhythms during emergency medical services resuscitation efforts was associated with increased odds of 1-month favorable neurological outcomes when the shock delivery time was less than 20 min.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 3%
Mexico 1 3%
Spain 1 3%
Unknown 34 92%

Demographic breakdown

Readers by professional status Count As %
Researcher 5 14%
Student > Ph. D. Student 5 14%
Student > Master 4 11%
Student > Doctoral Student 4 11%
Student > Bachelor 3 8%
Other 10 27%
Unknown 6 16%
Readers by discipline Count As %
Medicine and Dentistry 21 57%
Nursing and Health Professions 5 14%
Unspecified 1 3%
Psychology 1 3%
Veterinary Science and Veterinary Medicine 1 3%
Other 0 0%
Unknown 8 22%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 October 2014.
All research outputs
#15,168,964
of 25,373,627 outputs
Outputs from Critical Care
#4,986
of 6,554 outputs
Outputs of similar age
#131,036
of 262,419 outputs
Outputs of similar age from Critical Care
#82
of 118 outputs
Altmetric has tracked 25,373,627 research outputs across all sources so far. This one is in the 38th percentile – i.e., 38% of other outputs scored the same or lower than it.
So far Altmetric has tracked 6,554 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.8. This one is in the 22nd percentile – i.e., 22% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 262,419 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 118 others from the same source and published within six weeks on either side of this one. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.