Acute hospital administration of amiodarone and/or lidocaine in shockable patients presenting with out-of-hospital cardiac arrest: A nationwide cohort study

Chien Hua Huang, Ping Hsun Yu, Min Shan Tsai, Po Ya Chuang, Tzung Dau Wang, Chih Yen Chiang, Wei Tien Chang, Matthew Huei Ming Ma, Chao Hsiun Tang, Wen Jone Chen

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)292-298
Number of pages7
JournalInternational Journal of Cardiology
Volume227
DOIs
Publication statusPublished - Jan 15 2017

Fingerprint

Hospital Administration
Out-of-Hospital Cardiac Arrest
Amiodarone
Lidocaine
Cohort Studies
Heart Arrest
Survival Rate
Ventricular Fibrillation
Hospital Emergency Service
Shock
Anti-Arrhythmia Agents
Cardiopulmonary Resuscitation
National Health Programs
Insurance
Taiwan
Tachycardia
Resuscitation
Medical Records
Hospitalization
Odds Ratio

Keywords

  • 1-Year survival
  • Amiodarone
  • Lidocaine
  • Out-of-hospital cardiac arrest
  • Shockable rhythm

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

Acute hospital administration of amiodarone and/or lidocaine in shockable patients presenting with out-of-hospital cardiac arrest : A nationwide cohort study. / Huang, Chien Hua; Yu, Ping Hsun; Tsai, Min Shan; Chuang, Po Ya; Wang, Tzung Dau; Chiang, Chih Yen; Chang, Wei Tien; Ma, Matthew Huei Ming; Tang, Chao Hsiun; Chen, Wen Jone.

In: International Journal of Cardiology, Vol. 227, 15.01.2017, p. 292-298.

Research output: Contribution to journalArticle

Huang, Chien Hua ; Yu, Ping Hsun ; Tsai, Min Shan ; Chuang, Po Ya ; Wang, Tzung Dau ; Chiang, Chih Yen ; Chang, Wei Tien ; Ma, Matthew Huei Ming ; Tang, Chao Hsiun ; Chen, Wen Jone. / Acute hospital administration of amiodarone and/or lidocaine in shockable patients presenting with out-of-hospital cardiac arrest : A nationwide cohort study. In: International Journal of Cardiology. 2017 ; Vol. 227. pp. 292-298.
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abstract = "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.",
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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

PY - 2017/1/15

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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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