Pulmonary embolism (PE) is responsible for ~ 3% of Out-of-Hospital Cardiac Arrest (OHCA) and is associated with unfavorable prognoses [1]. We have recently shown that thrombolysis during resuscitation was associated with a better survival in the event of a proven pulmonary embolism [2]. The challenge is thus to identify, from the beginning of resuscitation, PE-related OHCA in order to deliver the proper treatment to the patient. This issue is highlighted by the premature stoppage of the TROICA trial [1], which showed no benefit of using thrombolysis in medical cardiac arrests. Our aim was to identify the factors associated with PE-related OHCA. We selected adults from the French National OHCA Registry, admitted to the hospital. This registry and the OHCA management by a mobile medical team have been previously described [3]. The present study was approved by the French Advisory Committee on Information Processing in Health Research. It was approved as a medical assessment registry without a requirement for patient consent. We assessed characteristics associated with PE-related OHCA with a univariable analysis (χ test, Fisher’s exact test or Student’s t test). A multivariate logistic regression model was then developed to identify the factors associated with PE with a P value < 0.20. Statistical analyses were performed using R software v3.6.1. From July 2011 to March 2018, 14,253 patients were admitted to the hospital. We excluded OHCAs whose cause was obvious from the beginning of the resuscitation (n = 2341) or where data was incomplete (n = 1150). The final analysis included 10,402 subjects. Two hundred sixty subjects (2%) were diagnosed with PE upon hospital admission by computed tomography pulmonary angiography (CTPA) or echocardiogram. The results of the univariate and multivariate analyses are presented in Table 1. The prevalence of PE was 22% among the population with nonshockable rhythm and history of thromboembolism.

中文翻译：

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改进肺栓塞相关院外心脏骤停的识别以优化复苏期间的溶栓治疗

肺栓塞 (PE) 约占院外心脏骤停 (OHCA) 的 3%，并且与不良预后有关 [1]。我们最近表明，在确诊肺栓塞的情况下，复苏期间溶栓与更好的生存相关 [2]。因此，挑战是从复苏开始就确定与 PE 相关的 OHCA，以便为患者提供适当的治疗。TROICA 试验 [1] 的过早停止突出了这个问题，该试验表明在医疗心脏骤停中使用溶栓治疗没有任何好处。我们的目的是确定与 PE 相关的 OHCA 相关的因素。我们从法国国家 OHCA 登记处选择了入院的成年人。之前已经描述了这种注册和 OHCA 由移动医疗团队管理 [3]。本研究已获得法国卫生研究信息处理咨询委员会的批准。它被批准为医学评估登记处，无需患者同意。我们通过单变量分析（χ2 检验、Fisher 精确检验或学生 t 检验）评估了与 PE 相关 OHCA 相关的特征。然后开发了多变量逻辑回归模型以识别与 P 值 < 0.20 的 PE 相关的因素。使用R软件v3.6.1进行统计分析。2011年7月至2018年3月，住院患者14253人。我们排除了在复苏开始时起因很明显的 OHCA (n = 2341) 或数据不完整 (n = 1150) 的 OHCA。最终分析包括 10,402 名受试者。260 名受试者 (2%) 在入院时通过计算机断层扫描肺血管造影 (CTPA) 或超声心动图诊断为 PE。单变量和多变量分析的结果见表 1。在具有不可电击心律和血栓栓塞病史的人群中，PE 的患病率为 22%。