title: Prehospital endotracheal intubation and survival after out-of-hospital cardiac arrest: results from the Korean nationwide registry.
abstract: OBJECTIVE
  Optimal out-of-hospital cardiac arrest (OHCA) airway management strategies are still controversial. Recent studies reported survival was higher among patients who received bag-valve-mask (BVM) than those receiving endotracheal intubation (ETI) or supraglottic airway (SGA). The aim of this study was to compare neurologically favorable survival outcomes among adult nontraumatic OHCA patients by prehospital airway.
  
  
  METHODS
  We used the Korean nationwide OHCA cohort database from 2010 to 2013. The inclusion criteria were all OHCA adults with presumed cardiac etiology, resuscitated by level-1 emergency medical technician. Patients were excluded if their information about the method of prehospital airway or clinical outcomes at hospital discharge could not be captured. The primary outcome was neurologically favorable survival to discharge. We compared the outcomes among 3 groups (ETI, SGA, or BVM) by prehospital airway using multivariable logistic regression with interaction model.
  
  
  RESULTS
  Of 98896 patients with OHCA, 32513 were included in analysis. Patients receiving BVM were 29684 and 2829 underwent advanced airway management including 1634 with SGA and 1195 with ETI. The odds of neurologically favorable survival to discharge was significantly higher in the ETI group compared to the BVM group (adjusted OR, 1.405; 95% CI, 1.1001-1.971). In the interaction model by witnessed status, the effect of ETI on good clinical outcomes was shown only in the patients whose arrest was unwitnessed.
  
  
  CONCLUSIONS
  In this Korean nationwide, population-based OHCA cohort, neurologically favorable survival to hospital discharge rates was significantly higher among patients who received ETI than those receiving BVM or SGA.
authors.affiliation: Dept. of Emergency Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro Bundang-gu, Seongnam 463-707, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital,101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: Kangkyoung83@hanmail.net.
authors.forename: Kyung
authors.initials: K
authors.lastname: Kang
authors.affiliation: Dept. of Emergency Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro Bundang-gu, Seongnam 463-707, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital,101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: emkity@gmail.com.
authors.forename: Taeyun
authors.initials: T
authors.lastname: Kim
authors.affiliation: Dept. of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital,101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: blueelf7@gmail.com.
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Ro
authors.affiliation: Dept. of Emergency Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro Bundang-gu, Seongnam 463-707, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital,101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: myda02@gmail.com.
authors.forename: Yu Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Dept. of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital,101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: skciva@gmail.com.
authors.forename: Kyung Jun
authors.initials: KJ
authors.lastname: Song
authors.affiliation: Dept. of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital,101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: shinsangdo@medimail.co.kr.
authors.forename: Sang Do
authors.initials: SD
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy*; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate