Epinephrine in Out of Hospital cardiac arrest NEJM 2018.pdf


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The

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Table 1. Characteristics of the Patients at Baseline.*
Characteristic
Mean age ±SD — yr
Sex — no. (%)
Male
Female
Initial cardiac rhythm — no. (%)
Shockable
Ventricular fibrillation
Pulseless ventricular tachycardia
Not otherwise identified with AED
Nonshockable
Asystole
Pulseless electrical activity
Bradycardia
Not otherwise identified with AED
Undetermined
Not identified
Missing data
Cause of cardiac arrest — no. (%)
Medical cause
Traumatic cause
Drowning
Drug overdose
Electrocution
Asphyxia
Not identified
Missing data
Witness of cardiac arrest — no. (%)
None
Paramedic
Bystander
Not identified
Missing data
CPR performed — no. (%)
By bystander
By paramedic during witnessed event
Not identified
Missing data

Epinephrine
(N = 4015)

Placebo
(N = 3999)

69.7±16.6

69.8±16.4

2609 (65.0)
1406 (35.0)

2584 (64.6)
1415 (35.4)

770 (19.2)
716 (17.8)
25 (0.6)
29 (0.7)
3149 (78.4)
2135 (53.2)
955 (23.8)
20 (0.5)
39 (1.0)

748 (18.7)
684 (17.1)
20 (0.5)
44 (1.1)
3181 (79.5)
2194 (54.9)
937 (23.4)
16 (0.4)
34 (0.9)

4 (0.1)
92 (2.3)

1 (<0.1)
69 (1.7)

3656 (91.1)
66 (1.6)
10 (0.2)
74 (1.8)
0
117 (2.9)
1 (<0.1)
91 (2.3)

3691 (92.3)
57 (1.4)
10 (0.3)
72 (1.8)
1 (<0.1)
81 (2.0)
2 (0.1)
85 (2.1)

1498 (37.3)
452 (11.3)
2013 (50.1)
1 (<0.1)
51 (1.3)

1505 (37.6)
470 (11.8)
1967 (49.2)
1 (<0.1)
56 (1.4)

2382 (59.3)
452 (11.3)
1 (<0.1)
69 (1.7)

2349 (58.7)
470 (11.8)
1 (<0.1)
84 (2.1)

* There
were no significant between-group differences in any of the baseline characteristics. AED denotes automated ex
ternal defibrillator, and CPR cardiopulmonary resuscitation.

outcome at hospital discharge, the probabilities
that the rate was at least 1 or 2 percentage points
higher with epinephrine were 1.9% and 0%, respectively (Fig. S4 in the Supplementary Appendix).
The other secondary outcomes are presented
in Table 3. Among the patients who were admitted to the hospital, there were no significant between-group differences in the length of stay in
716

the hospital or ICU (Figs. S5 and S6 in the Supplementary Appendix). There was no statistical
evidence of a modification in treatment effect by
such factors as the patient’s age, whether the
cardiac arrest was witnessed, whether CPR was
performed by a bystander, initial cardiac rhythm,
or response time or time to trial-agent administration (Fig. S7 in the Supplementary Appendix).

n engl j med 379;8 nejm.org  August 23, 2018

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