Factors associated with hospital transport in emergency medical services-attended out-of-hospital cardiac arrest.
Journal
Resuscitation
Journal Volume
223
Start Page
Article number 111088
ISSN
1873-1570
Date Issued
2026-06
Author(s)
Jhang, Hao-Teng
Liu, Ming-Zhou
Chen, Chun-Hsien
Hung, Tung-Hsiu
Wang, Tzu-Hsueh
Abstract
Background: Reported out-of-hospital cardiac arrest epidemiology reflects transported, emergency medical services-treated cases, whereas non-transported out-of-hospital cardiac arrest remains under-described. This study quantified non-transported out-of-hospital cardiac arrest and investigated factors associated with the decision to transport after emergency medical services recognition of out-of-hospital cardiac arrest. Methods: We conducted a retrospective, population-based cohort study of emergency medical services-attended non-traumatic adult out-of-hospital cardiac arrests in Hsinchu City and Hsinchu County, Taiwan, from January 1, 2022, to December 31, 2024. Canceled activations, patients not found, support-ambulance duplicate runs, and age younger than 18 years were excluded. The outcome was hospital transport after initiation of resuscitation. Univariable and multivariable logistic regression evaluated associations, including the interaction between the sex of the on-scene surrogate decision-maker and the sex of the patient. Results: Among 3504 emergency medical services-attended out-of-hospital cardiac arrests, 3339 were eligible; 2299 (68.9%) were non-transported out-of-hospital cardiac arrests and 1040 (31.1%) were transported. In multivariable analysis, transport was associated with witnessed arrest (adjusted odds ratio 1.754), bystander cardiopulmonary resuscitation (adjusted odds ratio 2.191), hypertension (adjusted odds ratio 1.406), and shorter or unknown last known normal condition versus more than 8 h (less than 2 h: adjusted odds ratio 7.073; 2–8 h: adjusted odds ratio 3.244; unknown: adjusted odds ratio 2.278). Transport was inversely associated with age (adjusted odds ratio 0.969 per year), malignancy (adjusted odds ratio 0.638), prior cerebrovascular accident (adjusted odds ratio 0.623), and arrest at home (adjusted odds ratio 0.320). Compared with male decision-maker/male patient dyads, transport odds were higher in all other decision-maker-patient sex dyads. Conclusions: Hospital transport after out-of-hospital cardiac arrest was associated with both recognizable markers of potential reversibility and decision-maker-patient sex dyads. Non-transported out-of-hospital cardiac arrest constituted a substantial proportion of emergency medical services-attended arrests in this system.
Subjects
Emergency medical services
Hospital transport
Non-transported out-of-hospital cardiac arrest
Out-of-hospital cardiac arrest
Termination of resuscitation
Publisher
Elsevier Ireland Ltd
Type
journal article