Advanced vs basic life support outcomes in treatment of out-of-hospital-cardiac-arrest: A registry-based…

Cohort studyThe American journal of emergency medicine· Jul 2026

Advanced vs basic life support outcomes in treatment of out-of-hospital-cardiac-arrest: A registry-based cohort study.

Ryan Silvagi, Enrique Rodriguez-Fohn, Ryan J Reece … Brian J O'Neil

Read paper

Resuscitation & Cardiac ArrestCohort studyTreatmentQ1IF 2.1

Advanced life support linked to higher return of spontaneous circulation in shockable arrest

Advanced vs basic life support outcomes in treatment of out-of-hospital-cardiac-arrest: A registry-based cohort study.

Ryan Silvagi … Brian J O'Neil

The American journal of emergency medicine · Jul 2026 · Q1 in Emergency Medicine

Background

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.

Purpose

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.

n = 6746 patients

Results

over a third of shockable arrests regained circulation with ALS, roughly double the BLS rate

S-ALS

37.9%

S-BLS

19.5%

NS-ALS

18.6%

NS-BLS

9.3%

More 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%).

ALS was associated with increased sustained ROSC for all initial rhythms (p < .001).

More results

S-ALS was associated with increased survival (p = .03), and neurologic outcome (p = .01) when compared to S-BLS.

“

Conclusion

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.

Advanced vs basic life support outcomes in treatment of out-of-hospital-cardiac-arrest: A registry-based cohort study.

Advanced vs basic life support outcomes in treatment of out-of-hospital-cardiac-arrest: A registry-based cohort study.

Related papers