September 12, 2025

Association Between Immediate defibrillation and Outcomes in Shockable Out-of-Hospital Cardiac Arrest: A Propensity Score Analysis

Key Points

Immediate defibrillation is linked to higher 1-month survival rates compared to delayed defibrillation, emphasizing its critical role.
Patients receiving immediate defibrillation had a 1-month survival of 32.5%, compared to 29.1% in those with delayed defibrillation.
The analysis utilized propensity score matching to compare outcomes in two groups of out-of-hospital cardiac arrest patients.
The findings support immediate defibrillation within 2 minutes, underlining the need for rapid EMS response during cardiac emergencies.

Abstract

This study aimed to examine the association between the timing of defibrillation by emergency medical service (EMS) and out-of-hospital cardiac arrest (OHCA) patient prognosis using a nationwide database. We included patients with non-traumatic OHCA aged ≥15 years from 2010 to 2019, with an initial shockable rhythm, who received EMS defibrillation. Patients were divided into 2 groups: defibrillation within 2 min of cardiopulmonary resuscitation (CPR; immediate defibrillation) or after 2 min (delayed defibrillation). The primary outcome was 1-month survival. We set the primary exposure to immediate defibrillation and employed a 1:1 propensity score matching. Multiple logistic regression analysis estimated the adjusted odds ratio (AOR) and 95% confidence interval (CI) for exposure and outcomes. After propensity score matching, 16,970 patients were included in each group. The 1-month survival were 32.5% and 29.1% for immediate defibrillation and delayed defibrillation, respectively. Immediate defibrillation was significantly associated with 1-month survival compared to delayed defibrillation (AOR 95% CI, 1.18 1.12, 1.24). Defibrillation within 2 min of starting CPR was associated with 1-month survival, emphasizing the importance of immediate defibrillation.

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