Cardiac arrest & resuscitation
Regional implementation of a prehospital advanced life support program with video-assisted physician direction and outcomes after out-of-hospital cardiac arrest
Main finding · Prehospital time intervalResult — go to the resultDifference-in-differences (greater increase in SALS regions) 4.12 minutes 95% CI 2.91–5.33Authors' conclusion
SALS regions showed greater increases in prehospital time and prehospital ROSC without significant improvements in survival to discharge or favorable neurological outcome, but the finding for prehospital time should be interpreted cautiously because differential pre-intervention trends were observed.
Study context
- Population
- Adult out-of-hospital cardiac arrest (OHCA) cases (aged ≥19 years) from 2 years before through 4 years after smart advanced life support (SALS) implementation in August 2015, South Koreacases included
- Participants
- 129,207 cases
- Exposure
- Pre- to post-implementation changes were compared between regions with and without SALS.
- Outcome
- Prehospital time interval
Methodological detailsdifference-in-differences and event-study analyses, OHCA surveillance system in South Korea
- Difference-in-differences and event-study analyses
- OHCA surveillance system in South Korea
Main finding
As reported in the abstract
Difference-in-differences (greater increase in SALS regions)
4.12 minutes
95% CI 2.91–5.33
SALS regions vs regions without SALS
difference-in-differences (greater increase in SALS regions) 4.12 minutes (95% CI 2.91–5.33)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Prehospital ROSC | difference-in-differences (greater increase in SALS regions) 1.35 percentage points (95% CI 0.56–2.15) | |
| Survival to dischargeNo significant additional improvement | difference-in-differences −0.35 percentage points (95% CI −1.31 to 0.62) | |
| Favorable neurological outcomeNo significant additional improvement | difference-in-differences −0.35 percentage points (95% CI −1.08 to 0.37) | |
| −2−10123Difference, percentage points (linear scale) |
Event-study analyses of pre-intervention trends
- Differential pre-intervention trends for prehospital time, but not for the other outcomes
Original publication
Regional implementation of a prehospital advanced life support program with video-assisted physician direction and outcomes after out-of-hospital cardiac arrest. Resuscitation. Published 20 October 2026. doi:10.
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