Assessing Key Factors Influencing Successful Resuscitation Outcomes in Out-of-Hospital Cardiac Arrest (OHCA)

<b>Background:</b> Out-of-hospital cardiac arrest (OHCA) is a critical health issue with survival influenced by multiple factors. This study analyzed resuscitation outcomes at the County Clinical Emergency Hospital of Sibiu, Romania, during pre-COVID-19 and pandemic periods. <b>Methods:</b> A retrospective analysis of 508 OHCA patients (2017-2020) assessed the return of spontaneous circulation (ROSC) as the primary endpoint. Statistical methods included decision tree analysis, logistic regression and ROC curve analysis to evaluate the predictive value of adrenaline dose and patient factors. <b>Results:</b> The mortality rate was 68.7%, with non-shockable rhythms predominant among fatalities. Rural patients, though younger, had lower ROSC rates than urban counterparts. Logistic regression showed that lower adrenaline doses (≤4 mg, OR 11.835 [95% CI: 6.726-20.27]; 4-6 mg, OR 2.990 [95% CI: 1.773-5.042]) were associated with better ROSC outcomes. <b>Conclusions</b>: A multivariable model (AUC = 0.773) incorporating demographics and pandemic status outperformed adrenaline dose alone (AUC = 0.711).