Cardiac arrest & resuscitation
Advanced Airway Practice Patterns and Out-of-Hospital Cardiac Arrest Outcomes
Authors' conclusion
In this cohort study, SGA use among EMS agencies increased over time. Although ROSC declined for all AA temporal practice patterns, the transition from ETI to SGA use at EMS agencies with lower baseline survival was associated with improved outcomes.
Study context
- Population
- Adults (≥18 years) with out-of-hospital cardiac arrest (OHCA) treated by emergency medical service (EMS) agencies with ≥25 OHCA episodes annually, CARES database, 2016–2022254 EMS agencies
- Participants
- 350,216 adults
- Exposure
- EMS agency advanced airway (AA) temporal practice patterns (before vs after 2019): ongoing endotracheal intubation (ETI), ongoing supraglottic airway (SGA), ETI to SGA, SGA to ETI
- Ongoing ETIn = 72
- Ongoing SGAn = 66
- ETI to SGAn = 67
- SGA to ETIn = 9
- Outcome
- ROSC and survival
Methodological detailsmulticentre registry, mixed-effects logistic regression, adjusted for Utstein variables
- Multicentre registry
- Mixed-effects logistic regression
- Adjusted for Utstein variables
Main finding
As reported in the abstract
ROSC, after vs before 2019
OR for ROSC (95% CI)
Ongoing ETI, after 2019 vs Ongoing ETI, before 2019ROSC 36.5% to 30.7%
0.80(0.77–0.82)
Ongoing SGA, after 2019 vs Ongoing SGA, before 2019ROSC 32.4% to 26.4%
0.75(0.73–0.78)
ETI to SGA, after 2019 vs ETI to SGA, before 2019ROSC 32.1% to 28.5%
0.88(0.85–0.91)
SGA to ETI, after 2019 vs SGA to ETI, before 2019ROSC 36.7% to 33.3%
0.92(0.83–1.03)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| ROSC, lower-performing agencies transitioning ETI to SGA (subgroup), after vs before 2019ROSC 25.7% to 29.1% | OR for ROSC 1.16 (95% CI 1.09–1.24) | |
| Survival, lower-performing agencies transitioning ETI to SGA (subgroup), after vs before 2019Survival 5.6% to 6.3% | OR for survival 1.17 (95% CI 1.04–1.32) | |
| 0.512Ratio (log scale) |
- Return of spontaneous circulation (ROSC), lower-performing agencies transitioning ETI to SGA (subgroup), after vs before 2019: 15 agencies, n = 20 860 patients
- Survival, lower-performing agencies transitioning ETI to SGA (subgroup), after vs before 2019: 15 agencies, n = 20 860 patients
Original publication
Advanced Airway Practice Patterns and Out-of-Hospital Cardiac Arrest Outcomes. JAMA Netw Open. Published 2 September 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →