Abstract 10908: The Association of Duration of Resuscitation and Long-Term Survival and Functional Outcomes After Out-of-Hospital Cardiac Arrest
Bibliographic record
Abstract
Introduction: Longer emergency medical system (EMS) CPR-to-ROSC interval has been shown to be linearly associated with worse hospital discharge outcomes for out-of-hospital cardiac arrest (OHCA). We hypothesized that this association extends post-discharge in hospital survivors. We investigated whether pre-arrest co-morbidities influence the duration of resuscitation. Methods: We included EMS-treated adult OHCA (Jan 2009 - Dec 2016) from British Columbia Cardiac Arrest Registry and provincial databases. Pre-OHCA characteristics were compared by ≤ 10, 10-20, and >20 min CPR-to-ROSC interval categories. Outcomes included survival and functional outcomes at hospital discharge and 1-year, as well as 3-year post-discharge survival. We examined the relationship between CPR-to-ROSC interval categories and 1 and 3-year survival using Kaplan-Meier (KM). We examined the relationship between the CPR-to-ROSC interval (continuous variable) with all outcomes using regression models. Results: Among 10,241 OHCA, 4604 (45%) achieved ROSC, with a median CPR-to-ROSC interval of 15.5 (IQR 9.0- 22.9) min. Diabetes, chronic kidney disease, and prior MI were associated with longer CPR-to-ROSC intervals. 1245 (12.2%) survived to hospital discharge. Among hospital survivors, KM survival at 1- and 3- years were 92% [95% CI 90-93%] and 84% [95% CI 82-86%] respectively; survival curves stratified by CPR-to-ROSC intervals were not statistically different (Figure). Longer CPR-to-ROSC interval was non-linearly associated with lower survival and functional outcomes at hospital discharge but not with post-discharge outcomes. Conclusion: Longer CPR-to-ROSC interval was associated with lower survival at hospital discharge and is influenced by pre-arrest co-morbidities. However, these intervals were not associated with long-term survival or functional outcome among hospital survivors, suggesting that the early risk of longer CPR-to-ROSC intervals does not persist.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".