Cardiac rhythm changes during transfer from the emergency medical service to the emergency department: a retrospective tertiary single-center analysis on prevalence and outcomes

Background: Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide. Cardiac rhythms of OHCA patients can change during transportation and transfer from emergency medical services (EMS) to the emergency department (ED). Objective: Our objective was to study the prevalence of cardiac rhythm changes during transfer from the EMS to the ED in OHCA patients and the possible association with clinical outcomes. Methods: We retrospectively studied adult OHCA patients admitted to the ED between January 2017 and December 2019. The primary outcome was the incidence of cardiac rhythm changes during transfer from EMS to the ED. Secondary outcomes were: ED survival, intensive care unit survival, hospital survival, and maximum Glasgow Coma Scale score during admission. Results: We included 625 patients, of whom there were 49 (7.8%) in the rhythm change group and 576 in the no rhythm change group. ED survival was significantly lower in the rhythm change group (26.5%) vs. the no rhythm change group (78.5%, p < 0.01). Conclusion: Cardiac rhythm changes can occur in OHCA patients during transfer from EMS to the ED. Our results showed some evidence that these changes are associated with a lower ED survival.