Abstract Sa101: Prehospital advanced airway management across age groups in out-of-hospital cardiac arrest: Registry-based cohort study from the Resuscitation Outcomes Consortium Epidemiologic Registry
Bibliographic record
Abstract
Background: Emergency medical services clinicians commonly perform advanced airway management (AAM: i.e., supraglottic airway placement and endotracheal intubation) for out-of-hospital cardiac arrest (OHCA). Nevertheless, the heterogeneity of the treatment effect of prehospital AAM across age groups is still unclear. Aim: To determine the association between prehospital AAM and survival after OHCA, compared with no AAM, across age groups. Methods: This cohort study used the Resuscitation Outcomes Consortium Epidemiologic Registry database, a prospective OHCA registry at ten sites in the US and Canada from 2011 through 2015. Patients were stratified into ten sub-cohorts based on their first documented rhythm (shockable or non-shockable) and five age groups (0-9 years; 10-24; 25-44; 45-64; or ≥65) given the potential impact of rhythm and age on effect modification. To address resuscitation time bias, patients who received AAM during cardiopulmonary resuscitation (CPR) were sequentially matched with patients at risk of receiving AAM within the same minute based on time-dependent propensity scores. Matching was performed in each sub-cohort, and the matched sub-cohorts were integrated for the main analysis. The primary outcome was survival to hospital discharge. Results: Of the 44,403 eligible patients, 39,157 (88.2%) received prehospital AAM during CPR. After time-dependent propensity score sequential matching, 29,973 who received AAM were matched with patients who had not yet received AAM at the same minute. AAM was associated with survival: 5.4% vs 4.8%, risk ratio (RR) 1.40 (95% CI 1.30-1.51). The associations were similar toward better survival in both the shockable (RR 1.27 [95% CI 1.17-1.38]) and non-shockable (RR 1.75 [95% CI 1.53-2.01]) cohorts. There was no apparent heterogeneity of the treatment effect of AAM on survival in all age groups: 0-9 years, RR 1.07 (95% CI 0.45-2.56); 10-24 years, 1.61 (1.07-2.45); 25-44 years, 1.68 (1.35-2.10); 45-64 years, 1.33 (1.19-1.48); 65 years or older, 1.40 (1.23-1.59). Conclusions: In this study of the large multicenter OHCA registry in North America, prehospital AAM was associated with survival to hospital discharge regardless of the first documented rhythm. No apparent heterogeneity was found in the associations between AAM and survival among all age groups, suggesting that both pediatric and adult populations might benefit from prehospital AAM.
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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 | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".