Impact of epinephrine administration frequency in out-of-hospital cardiac arrest patients: a retrospective analysis in a tertiary hospital setting

INTRODUCTION: Epinephrine is recommended for patients with out-of-hospital cardiac arrest (OHCA). However, whether epinephrine improves or adversely affects OHCA outcomes is controversial. OBJECTIVES: This study aims to determine whether the frequency of epinephrine administration impacts OHCA patient survival. METHODS: We conducted a retrospective analysis of OHCA cases registered in the Emergency Department at King Fahd University Hospital, Saudi Arabia between 2005 and 2015. The primary outcomes were mortality and survival rates until discharge. The impact of epinephrine administration timing and frequency on patient survival was analyzed. RESULTS: Data from 300 OHCA cases were analyzed. Among them, 66.3% were men, and the overall mean age of 50.4 ± 20.6 years. The overall survival rate until hospital discharge was 12%. There was no statistically significant difference between in gender, age, or time interval to the first epinephrine dose in the survival and non-survival groups. Only the number of epinephrine doses was related to the survival outcome. CONCLUSION: Non-survivors received significantly more epinephrine doses compared with survivors. However, a causal relationship between OHCA patient survival and epinephrine dose and time cannot be confirmed. Further studies are needed to investigate whether the long-term outcomes in OHCA patients are influenced by the timing and frequency of epinephrine administration.