Predictors of early and late survival after out-of-hospital cardiac arrest in which asystole was the first recorded arrhythmia on scene

Resuscitation. 1994 Jul;28(1):27-36. doi: 10.1016/0300-9572(94)90051-5.


Background: A large proportion of patients who suffer out-of-hospital cardiac arrest have asystole as the initial recorded arrhythmia. Since they have a poor prognosis, less attention has been paid to this group of patients.

Aim: To describe a consecutive population of patients with out-of-hospital cardiac arrest with asystole as the first recorded arrhythmia and to try to define indicators for an increased chance of survival in this population.

Setting: The community of Gothenburg.

Patients: All patients who suffered out-of-hospital cardiac arrest during 1981 to 1992 and were reached by our emergency medical service (EMS) system and where cardiopulmonary resuscitation (CPR) was attempted.

Results: In all there were 3434 cardiac arrests of which 1222 (35%) showed asystole as the first recorded arrhythmia. They differed from patients with ventricular fibrillation by being younger, including more women and having a longer interval between collapse and arrival of the first ambulance. In all 90 patients (7%) were hospitalized alive and 20 (2%) could be discharged from hospital. Independent predictors for an increased chance of survival were: (a) a short interval between the collapse and arrival of the first ambulance (P < 0.001) and the time the collapse occurred (P < 0.05). Initial treatment given in some cases with adrenaline, atropine and tribonate were not associated with an increased survival.

Conclusions: Of all the patients with out-of-hospital cardiac arrest, 35% were found in asystole. Of these, 7% were hospitalized alive and 2% could be discharged from hospital. Efforts should be made to improve still further the interval between collapse and arrival of the first ambulance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arrhythmias, Cardiac / complications
  • Arrhythmias, Cardiac / diagnosis
  • Atropine / therapeutic use
  • Bicarbonates / therapeutic use
  • Cardiopulmonary Resuscitation*
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Emergencies
  • Epinephrine / therapeutic use
  • Female
  • Heart Arrest / diagnosis
  • Heart Arrest / etiology
  • Heart Arrest / mortality*
  • Heart Arrest / therapy*
  • Hospital Mortality
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Survival Rate
  • Time Factors
  • Tromethamine / therapeutic use
  • Ventricular Fibrillation / complications
  • Ventricular Fibrillation / diagnosis


  • Bicarbonates
  • Tromethamine
  • Tribonate
  • Atropine
  • Epinephrine