Cardiac arrest & resuscitation
Incidence and outcomes of out-of-hospital cardiac arrest from initial asystole: a systematic review and meta-analysis
Authors' conclusion
Initial asystolic OHCA made up 53% of all EMS-treated patients and pooled survival rates were extremely poor.
Study context
- Population
- Emergency Medical Services (EMS)-attended or treated out-of-hospital cardiac arrest (OHCA) from initial asystole, studies 1990 to August 2024
- Participants
- 540,054 participants · 82 studies
- Outcome
- Survival to hospital discharge or 30-days
Methodological detailsrandom-effects models, meta-regression, High clinical and statistical heterogeneity, Quality assessed with the Joanna Briggs Institute tool for prevalence studies
- Random-effects models
- Meta-regression
- High clinical and statistical heterogeneity
- Quality assessed with the Joanna Briggs Institute tool for prevalence studies
Pooled result
As reported in the abstract
Survival to hospital discharge or 30-days (pooled proportion)
Pooled proportion of survivors to hospital discharge or 30-days
1.5%
95% CI 1.2%, 1.8%; I2 = 97%
Further pooled results
Proportion of EMS-treated OHCA with initial asystole
- Pooled proportion
- 53.0% (95% CI: 49.0%, 58.0%; I2 = 100%)
Event survival
- Pooled proportion
- 11.6% (95% CI 6.5%, 17.8%; I2 = 99%)
Prehospital ROSC
- Pooled proportion
- 16.0% (95% CI 14.0%, 17.0%; I2 = 100%)
Neurologically favourable survival · longest follow-up
- Pooled proportion
- 0.6% (95% CI 0.5%, 0.8%; I2 = 100%)
Incidence of EMS-treated asystolic OHCA
- Pooled incidence, cases per 100,000 person-years
- 11.0 (95% CI: 10.5, 11.5; I2 = 100%)
Factors associated with survival to hospital discharge or 30-days (adjusted analysis)
- Population type, study duration, highest EMS skill level and region significantly associated with the primary outcome
Original publication
Incidence and outcomes of out-of-hospital cardiac arrest from initial asystole: a systematic review and meta-analysis. Resuscitation. Published 3 May 2025. doi:10.
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