Association between the timing of prehospital epinephrine administration and patient outcomes after out-of-hospital cardiac arrest in Korea: a nationwide observational study
Given the strong association found here, maintaining aggressive efforts to deliver epinephrine within 20 minutes of arrest onset should remain a high priority for EMS protocols. While this is observational data from one region, the trend suggests that every minute counts toward better neurological outcomes; therefore, minimizing prehospital delays remains crucial at the bedside.
This nationwide observational study from Korea examined whether the timing of prehospital epinephrine administration impacts outcomes following non-traumatic out-of-hospital cardiac arrest (OHCA). The authors compared patients who received epinephrine early (within 20 minutes of arrest) versus those with delayed administration. Their analysis, using propensity score matching and multivariable regression on a large cohort, found a clear association: earlier epinephrine was linked to better survival rates and significantly improved neurological outcomes, specifically achieving a Cerebral Performance Category (CPC) of 1–2 at discharge. Furthermore, the data suggested a dose-response relationship, showing that every minute of delay correlated with lower odds of good CPC, with delays exceeding 30 minutes being particularly detrimental. Overall, these results strongly reinforce the clinical value of rapid advanced life support intervention in the prehospital setting.