Time to epinephrine treatment is associated with the risk of mortality in children who achieve sustained ROSC after traumatic out-of-hospital cardiac arrest

Lin, Yan-Ren; Wu, Meng-Huan; Chen, Tren-Yi; Syue, Yuan-Jhen; Yang, Mei-Chueh; Lee, Tsung-Han; Lin, Chih-Ming; Chou, Chu-Chung; Chang, Chin-Fu; Li, Chao-Jui

doi:10.1186/s13054-019-2391-z

Critical Care

Table 4 Cox regression analysis adjusting for potential risk factors of mortality

From: Time to epinephrine treatment is associated with the risk of mortality in children who achieve sustained ROSC after traumatic out-of-hospital cardiac arrest

Variables^c	Children with traumatic OHCA and sustained ROSC
	Total (n = 222)	HS OHCA (n = 147)	Non-HS OHCA (n = 75)
	HR (95% CI)	HR (95% CI)	HR (95% CI)
Time from the scene to the hospital (min)	1.03 (1.01–3.23)^a	1.04 (1.31–1.56)^a	1.02 (1.52–4.83)^a
Achievement of initial volume resuscitation
No^a	1.96 (1.08–3.72)^a	2.84 (1.12–3.06)^a	1.78 (0.60–4.60)
Yes^b	1.00	1.00	1.00
Early tranexamic acid administration
No^a	1.22 (1.04–2.53)^a	1.47 (1.10–2.39)^a	1.30 (0.67–3.22)
Yes^b	1.00	1.00	1.00
Year of ED admission
2011–2015	0.84 (0.66–3.01)	0.76 (0.43–1.34)	0.88 (0.73–1.55)
2006–2010	0.96 (0.34–4.21)	1.10 (0.57–2.10)	0.93 (0.46–5.33)
< 2006^b	1.00	1.00	1.00
Consciousness level (GCS score)
4–7^a	5.12 (2.53–10.50)^a	7.62 (2.85–19.87)^a	7.52 (2.64–29.30)^a
3^a	12.50 (5.71–23.38)^a	15.05 (4.97–45.45)^a	19.22 (3.47–105.98)^a
> 7^b	1.00	1.00	1.00
Cardiac rhythm
Nonsinus rhythm	0.96 (0.58–1.55)	1.23 (0.67–3.11)	1.13 (0.52–1.73)
Sinus rhythm^b	1.00	1.00	1.00
Heart rate
Tachycardia	1.55 (0.93–2.60)	1.42 (0.76–2.81)	1.59 (0.32–4.66)
Bradycardia	2.51 (0.46–4.32)	2.11 (0.78–3.32)	4.01 (0.90–19.09)
Normal^b	1.00	1.00	1.00
Mean blood pressure
Hypertension	0.91 (0.74–2.55)	1.25 (0.88–2.48)	0.55 (0.54–1.22)
Hypotension	1.05 (0.64–1.88)	1.07 (0.74–3.01)	0.94 (0.31–2.57)
Normal^b	1.00	1.00	1.00
Urine output
< 0.5 mL/kg/h^a	1.93 (1.45–3.01)^a	2.90 (2.11–8.11)^a	1.52 (0.48–3.72)
1–0.5 mL/kg/h^a	1.70 (1.42–3.89)^a	1.96 (1.42–3.86)^a	1.89 (0.76–9.81)
> 1 mL/kg/h^b	1.00	1.00	1.00
Metabolic acidosis
Yes	0.74 (0.49–1.13)	0.92 (0.33–1.01)	0.83 (0.55–4.01)
No^b	1.00	1.00	1.00
Time to epinephrine treatment
Early^a	2.86 (1.98–5.47)^a	4.52 (2.73–15.91)^a	0.51 (0.10–2.62)
Middle	0.83 (0.45–1.54)	0.60 (0.26–1.34)	0.39 (0.76–1.94)
Late^b	1.00	1.00	1.00

^aSignificant factor
^bReference group
^cAll variables were also adjusted according to patient characteristics (age, sex), pre/in-hospital information (major site of injury, mechanism of injury, type of trauma, initial cardiac rhythm), and interaction terms (time to epinephrine treatment × potential effective factor, including time from the scene to the hospital, achievement of initial volume resuscitation, early tranexamic acid administration, consciousness level, and urine output)

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ISSN: 1364-8535

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