Ahmet Turla, Hüseyin Kara, Nilay Cankurt Ayar, Berna Aydin, Fulya Zeynep Levent, Oğuzhan Külbaz
The importance of length and area estimate for forensic medicine without using a measurement tool
Turkish journal of medical sciences
contrary advanced cardiac life support guidelines recommend immediate defibrillation shockable inhospital cardiac arrest ihca epinephrine administration first defibrillation common associated lower survival patientlevel whether practice varies across hospitals association hospitallevel ihca survival remains unknown purpose study determine hospital variation rates epinephrine administration defibrillation shockable ihca association ihca survival observational cohort study five hundred thirteen hospitals participating get guidelines resuscitation registry total 37668 adult patients ihca due initial shockable rhythm 2000 2019 epinephrine first defibrillation using multivariable hierarchical regression examined hospital variation epinephrine administration first defibrillation association hospitallevel rates riskadjusted survival median hospital rate epinephrine administration defibrillation 188 large variation across sites range 0688 median odds ratio 154 95 ci 147161 major teaching status annual ihca volume associated hospital rate epinephrine administration defibrillation compared hospitals lowest rate epinephrine administration defibrillation q1 stepwise decline riskadjusted survival hospitals higher rates epinephrine administration defibrillation q1 443 q2 434 q3 419 q4 403 p trend 0001 administration epinephrine defibrillation shockable ihca common varies markedly across us hospitals hospital rates epinephrine administration defibrillation associated significant stepwise decrease hospital rates riskadjusted survival efforts prioritize immediate defibrillation patients shockable ihca avoid early epinephrine administration urgently needed