Out-of-hospital cardiac arrest secondary to electrocution: Characteristics and outcomes

Aidan Smith; Rod Mason; Jake Kilsby; Ashanti Dantanarayana; Tony Walker; Ziad Nehme

doi:10.1016/j.resuscitation.2025.110696

Out-of-hospital cardiac arrest secondary to electrocution: Characteristics and outcomes

Resuscitation. 2025 Jun 30:110696. doi: 10.1016/j.resuscitation.2025.110696. Online ahead of print.

Authors

Aidan Smith¹, Rod Mason², Jake Kilsby³, Ashanti Dantanarayana⁴, Tony Walker⁵, Ziad Nehme⁶

Affiliations

¹ Department of Paramedicine, Monash University, Frankston, Victoria, Australia; Ambulance Victoria, Doncaster, Victoria, Australia. Electronic address: aidan.smith@ambulance.vic.gov.au.
² Department of Paramedicine, Monash University, Frankston, Victoria, Australia. Electronic address: rod.mason@monash.edu.
³ Ambulance Victoria, Doncaster, Victoria, Australia. Electronic address: jake.kilsby@ambulance.vic.gov.au.
⁴ Ambulance Victoria, Doncaster, Victoria, Australia. Electronic address: ashanti.dantanarayana@ambulance.vic.gov.au.
⁵ Department of Paramedicine, Monash University, Frankston, Victoria, Australia. Electronic address: tony.walker@monash.edu.
⁶ Department of Paramedicine, Monash University, Frankston, Victoria, Australia; Ambulance Victoria, Doncaster, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Victoria, Australia. Electronic address: ziad.nehme@ambulance.vic.gov.au.

PMID: 40602479
DOI: 10.1016/j.resuscitation.2025.110696

Abstract

Aim: To characterise the epidemiology of Out-of-Hospital Cardiac Arrests (OHCA) secondary to electrocution and determine its association with the initial arrest rhythm and patient outcomes.

Method: Between 2000 and 2023, we retrospectively compared OHCA secondary to electrocution with medical and other non-medical aetiologies. Multivariable logistic regression was used to assess the risk-adjusted odds of presenting in a shockable rhythm and patient outcomes.

Results: Of the 118,677 OHCA cases included in the study, 113 (0.1%) were secondary to electrocution. The crude incidence was 0.11 per 100,000 person-years, reducing significantly over time (p <0.001). Electrocution cases were more likely to be male, occur in a workplace, and present in a shockable rhythm compared to medical and non-medical causes. After adjustment for arrest characteristics, the odds of presenting in a shockable rhythm were similar between electrocution and medical causes (AOR 1.08, 95% CI: 0.59, 2.01; p =0.790) but lower for non-medical causes (AOR 0.07, 95% CI: 0.04, 0.14; p <0.001). Electrocution had higher unadjusted odds of survival to hospital discharge when compared to medical causes (OR 0.21, 95% CI: 0.21, 0.80; p = 0.009) and non-medical causes (OR 0.20, 95% CI: 0.10, 0.39; p < 0.001), but this was not significant after adjustment for differences in arrest characteristics.

Conclusion: Electrocution cases had a similar likelihood of presenting in a shockable rhythm to medical causes. Electrocution was not an independent predictor of survival, with favourable prognosis appearing to be attenuated by other factors, including younger age and a higher proportion of initial shockable rhythms.

Keywords: Out-of-hospital cardiac arrest; electrical injury; electrocution; emergency medical service; resuscitation.