Journal of Yeungnam Medical Science

Original articles

Emergency and Critical Care Medicine
Shockable rhythm as an independent prognostic factor in patients with non-ST elevation undergoing percutaneous coronary intervention after out-of-hospital cardiac arrest: a registry-based cohort study: Su Jeong Shin, Jae Yun Ahn, Sung Bae Moon, Do Won Lee, Yun Jeong Kim, Dong Eun Lee, Jung Ho Kim, Sang Hun Lee, Hyung Jun Hoh, Hyun Wook Ryoo; J Yeungnam Med Sci. 2026;43:62. Published online September 4, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.62 [Epub ahead of print]

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Abstract PDF: Background
Although the timing and indications for coronary angiography (CAG) after out-of-hospital cardiac arrest (OHCA) have been widely studied, the characteristics associated with favorable outcomes in patients with non-ST-elevation (non-STE) undergoing percutaneous coronary intervention (PCI) remain unclear.
Methods
This retrospective cohort study used a citywide, prospectively collected OHCA registry in Daegu, Korea (2018–2022), which included adult patients with non-STE after OHCA who underwent both CAG and PCI. Given the limited number of outcome events relative to the covariates, Firth’s penalized logistic regression identified factors independently associated with survival to hospital discharge and favorable neurological outcomes (cerebral performance category 1–2).
Results
Of the 5,026 patients treated by Emergency Medical Services for OHCA, 371 underwent CAG; 258 (69.5%) had no ST elevation on the initial electrocardiogram, and 105 (40.7%) underwent PCI and formed the study cohort. Sixty-nine patients (65.7%) survived to discharge, and 55 (52.4%) had favorable neurological outcomes. Initial shockable rhythm (adjusted odds ratio [aOR], 5.38; 95% confidence interval [CI], 1.77–18.02), prehospital return of spontaneous circulation (ROSC) (aOR, 10.30; 95% CI, 3.62–33.06), and shorter scene time interval (aOR, 0.88 per minute; 95% CI, 0.79–0.98) were independently associated with survival. Initial shockable rhythm (aOR, 11.02; 95% CI, 3.39–43.00) and prehospital ROSC (aOR, 11.69; 95% CI, 3.69–45.03) were independently associated with favorable neurological outcomes.
Conclusion
Among patients with non-STE after OHCA who underwent CAG and PCI, initial shockable rhythm and prehospital ROSC were independently associated with survival and neurological outcomes, whereas shorter scene time interval was independently associated with only survival. Because the cohort was restricted to patients who survived to undergo PCI, these findings reflect prognostic stratification within an already treated group and cannot infer the benefits of CAG or PCI. Therefore, prospective confirmation is warranted.

Emergency and Critical Care Medicine
Outcomes in patients with out-of-hospital cardiac arrest according to prehospital advanced airway management timing: a retrospective observational study: Sang-Hun Lee, Hyun Wook Ryoo; J Yeungnam Med Sci. 2024;41(4):288-295. Published online July 18, 2024; DOI: https://doi.org/10.12701/jyms.2024.00332

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Background
In patients with out-of-hospital cardiac arrest (OHCA), guidelines recommend advanced airway (AA) management at the advanced cardiovascular life support stage; however, the ideal timing remains controversial. Therefore, we evaluated the prognosis according to the timing of AA in patients with OHCA.
Methods
We conducted a retrospective observational study of patients with OHCA at six major hospitals in Daegu Metropolitan City, South Korea, from August 2019 to June 2022. We compared groups with early and late AA and evaluated prognosis, including recovery of spontaneous circulation (ROSC), survival to discharge, and neurological evaluation, according to AA timing.
Results
Of 2,087 patients with OHCA, 945 underwent early AA management and 1,142 underwent late AA management. The timing of AA management did not influence ROSC in the emergency department (5–6 minutes: adjusted odds ratio [aOR], 0.97; p=0.914; 7–9 minutes: aOR, 1.37; p=0.223; ≥10 minutes: aOR, 1.32; p=0.345). The timing of AA management also did not influence survival to discharge (5–6 minutes: aOR, 0.79; p=0.680; 7–9 minutes: aOR, 1.04; p=0.944; ≥10 minutes: aOR, 1.86; p=0.320) or good neurological outcomes (5–6 minutes: aOR, 1.72; p=0.512; 7–9 minutes: aOR, 0.48; p=0.471; ≥10 minutes: aOR, 0.96; p=0.892).
Conclusion
AA timing in patients with OHCA was not associated with ROSC, survival to hospital discharge, or neurological outcomes.

Citations

Citations to this article as recorded by

The association of prehospital advanced airway management time and outcome in out-of hospital cardiac arrest patients
Thongpitak Huabbangyang, Pramote Papukdee, Rossakorn Klaiangthong, Fahsai Jaibergban, Pannika Paharat, Patcharaporn Doungkaew, Fatiha Chanthep, Menatthinee Suntimetaneedol, Sitthichai Chuanart
Scientific Reports.2026;[Epub] CrossRef
Early Advanced Airway Management and Clinical Outcomes in Out-of-Hospital Cardiac Arrest: A Nationwide Observational Study
Jung Ho Lee, Dahae Lee, Eujene Jung, Hyun Ho Ryu, Jeong Ho Park, Young Sun Ro, Kyoung Jun Song
Journal of Clinical Medicine.2025; 14(21): 7652. CrossRef

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