The American journal of emergency medicine
July 23, 2026 · via Europe PMC
Advanced vs basic life support outcomes in treatment of out-of-hospital-cardiac-arrest: A registry-based cohort study.
Silvagi R, Rodriguez-Fohn E, Reece RJ, +8 more, O'Neil BJ.
AI summary — for doctors, generated from the abstract only
In Detroit OHCA registry data, advanced life support was associated with higher sustained ROSC across all rhythms and better survival and neurologic outcome in shockable rhythms compared with BLS alone.
What was studied
A retrospective CARES registry analysis of 6,746 non-traumatic OHCA patients in Detroit (2016-2021) comparing ALS vs BLS care stratified by initial rhythm.
Key findings
- Mean age 62.6; 84.6% Black.
- ROSC: shockable ALS 37.9% vs BLS 19.5%; non-shockable ALS 18.6% vs BLS 9.3%.
- ALS associated with increased sustained ROSC for all rhythms; specific statistic not fully captured in the abstract.
- Improved survival to discharge and favorable neurologic outcome with ALS in shockable rhythms; specific statistic not fully captured in the abstract.
Clinical relevance
This supports the value of ALS response for OHCA, particularly for shockable rhythms, though observational registry data may be confounded by response times and system factors.
Who should care
Limitations
Retrospective single-city registry; differences in response times, bystander CPR, and other factors may confound comparisons; some results truncated in the abstract.
Paramedic-level care was linked to more ROSC in all arrests and better survival in shockable ones.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Importance
The absolute effect on outcomes with Advanced, (ALS) as compared to Basic Life Support, (BLS) care in Out of Hospital Cardiac Arrest, (OHCA) remains unclear.
Objective
To assess the association of ALS compared to BLS alone prehospital care on return of spontaneous circulation, (ROSC), survival to hospital discharge, and neurological outcome in OHCA in Detroit, MI.
Methods
Retrospective analysis of 6746 patients from the Cardiac Arrest Registry to Enhance Survival database from January 2016 to December 2021 who had non-traumatic OHCA and received cardiopulmonary resuscitation. Cohorts were grouped by ALS v BLS care then initial rhythm and then compared by chi-squared, multivariable logistic, and multinomial regression analysis for outcomes of sustained ROSC, survival to hospital discharge and favorable neurological outcome at hospital discharge. The BLS cohort is defined by units that provided manual CPR, automated rhythm and defibrillation, airway management, but no endotracheal intubation or parenteral medications. ALS care was defined as manual rhythm interpretation, manual defibrillation, intravenous or intraosseous drug administration or endotracheal intubation.
Results
Mean age was 62.6 years (SD-16.7), with 56.3% male and 84.6% Black. Cohort breakdown: shockable ALS (S-ALS; n = 330, 4.9%); shockable BLS (S-BLS; n = 466, 6.9%); non-shockable ALS (NS-ALS; n = 2793, 41.4%); non-shockable BLS (NS-BLS; n = 3157, 46.8%). ROSC rates by cohort: S-ALS (37.9%); S-BLS (19.5%); NS-ALS (18.6%); NS-BLS (9.3%). ALS was associated with increased sustained ROSC for all initial rhythms (p < .001). S-ALS was associated with increased survival (p = .03), and neurologic outcome (p = .01) when compared to S-BLS.
Conclusion & relevance
Advanced Life Support, relative to Basic Life Support alone, was associated with improved sustained return of spontaneous circulation across all initial rhythms, and improved survival to discharge and favorable neurologic outcome in shockable initial rhythms.
DOI
10.1016/j.ajem.2026.07.021
PMID
42546549
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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