Cardiac arrest & resuscitation
Association of epinephrine and outcome in cardiac arrest with refractory shockable rhythm: a population-based, propensity-score matched analysis
Authors' conclusion
In a large population-based registry of patients experiencing refractory ventricular fibrillation, epinephrine use was consistently associated with worse outcome using various methodological approaches.
Study context
- Population
- OHCA with persistent ventricular fibrillation after at least 3 defibrillations, Paris and suburbs, 15/05/2011 to 31/12/2021
- Participants
- 3,163 participants
- Exposure
- Epinephrine vs no epinephrine
- Epinephrinen = 2,572
- Outcome
- Survival with favorable neurological outcome (Cerebral Performance Categories 1 or 2)
- Follow-up
- Hospital discharge
Methodological detailsmulticentric, population-based, propensity-score matched, inverse probability weighting
- Multicentric
- Population-based
- Propensity-score matched
- Inverse probability weighting
Main finding
As reported in the abstract
Survival with favorable neurological outcome (CPC 1 or 2 at hospital discharge)
Epinephrine vs No epinephrineAOR for favorable neurological outcome (95% CI)P value
Multivariate adjustment
0.24(0.19–0.31)
P < 0.001Propensity-score adjustment
0.24(0.18–0.31)
P < 0.001Propensity-score matching
0.40(0.31–0.51)
P < 0.001Observational data: associations, not effects.
Further findings
Favorable outcome, propensity-score matching (sensitivity analysis)
- Matched cohort
Original publication
Association of epinephrine and outcome in cardiac arrest with refractory shockable rhythm: a population-based, propensity-score matched analysis. Crit Care. Published 19 June 2025. doi:10.
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