Supplementary Online Content

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1 Supplementary Online Content Hasegawa K, Hiraide A, Chang Y, Brown DFM. Association of prehospital advancied airway management with neurologic outcome and survival in patients with out-of-hospital cardiac arrest. JAMA. doi: /jama etable 1. Missing Data for Variables Included in Unconditional Regression Models, Stratified by Airway Management etable 2. Selected Variables in Conditional Logistic Regression Models of Airway Management vs. Favorable Neurological Outcome Among Propensity-Matched Patients This supplementary material has been provided by the authors to give readers additional information about their work.

2 etable 1. Missing Data for Variables Included in Unconditional Regression Models, Stratified by Airway Management Number Missing (%) Advanced Airway Bag-valve-mask Ventilation Management Variable (n = , 43%) (n= , 57%) ROSC 23 (<0.1) 10 (<0.1) 1-month survival 4 (<0.1) 5 (<0.1) Neurologically favorable survival 366 (0.1) 444 (0.1) Airway management a 0 0 Year 5 (<0.1) 13 (<0.1) Age a 0 0 Sex 0 0 Initial cardiac rhythm 3 (<0.1) 4 (<0.1) Type of bystander-witness status 7634 (2.7) 8490 (2.3) CPR by bystander 4771 (1.7) 4659 (1.3) Use of public-access AED by bystander 2938 (1.0) 2836 (0.8) Emergency lifesaving technician present in 21 (<0.1) 26 (<0.1) Physician present in 132 (<0.1) 198 (0.1) Defibrillation by emergency responder 1654 (0.6) 2015 (0.5) Epinephrine administered 2264 (0.8) 3805 (1.0) Insertion of intravenous line 1211 (0.4) 2052 (0.6) Prefecture 0 0 Call to CPR by emergency responder 146 (<0.1) 194 (<0.1) Call to hospital arrival 28 (<0.1) 52 (<0.1) Abbreviations: ROSC, return of spontaneous circulation; CPR, cardiopulmonary resuscitation; AED, automated external defibrillator. a Patients with unknown airway management status or age were excluded from the study.

3 Favorable Neurological Outcome Among Propensity-Matched Patients a Neurologically Unadjusted Model Adjusted for Selected Adjusted for All Favorable Survival no. (%) Variables b Variables c Variable (n = ) (n = ) (n = ) Airway management Advanced airways 1954 (1.1) 0.33 ( ) 0.37 ( ) 0.37 ( ) Endotracheal intubation 257 (1.0) 0.31 ( ) 0.45 ( ) 0.42 ( ) Supraglottic airways 1697 (1.1) 0.33 ( ) 0.36 ( ) 0.36 ( ) Bag-valve-mask ventilation 5799 (3.2) Reference Reference Reference Age, decile 0.80 ( ) 0.82 ( ) Sex Male 5597 (2.7) 1.18 ( ) 1.20 ( ) Female 2156 (1.5) Reference Reference Etiology of cardiac arrest Cardiac 5974 (3.0) 1.11 ( ) 1.10 ( ) Non-cardiac 1779 (1.1) Reference Reference Initial cardiac rhythm VF or VT 4041 (14.9) ( ) 3.82 ( ) Pulseless electrical 3712 (1.1) Reference Reference activity/asystole Type of bystander-witness status No witness 1344 (0.7) Reference Reference Layperson 4832 (4.0) 3.66 ( ) 3.61 ( ) Healthcare providers 1528 (6.7) ( ) ( ) CPR by bystander No bystander CPR 4376 (2.1) Reference Reference Compression-only CPR 1988 (2.1) 0.91 ( ) 0.94 ( ) Conventional CPR 1272 (2.8) 0.96 ( ) 1.03 ( ) Use of public-access AED by 271 (14.6) 4.66 ( ) 3.55 ( ) bystander No use of public-access AED 7409 (2.1) Reference Reference by bystander

4 Favorable Neurological Outcome Among Propensity-Matched Patients a (continued) Neurologically Unadjusted Model Adjusted for Selected Adjusted for All Favorable Survival no. (%) Variables b Variables c Variable (n = ) (n = ) (n = ) Epinephrine administration 332 (1.7) 0.47 ( ) 0.49 ( ) No epinephrine administration 7350 (2.2) Reference Reference Time interval Call to CPR by emergency 0.97 ( ) 0.95 ( ) responder Call to hospital arrival 1.00 ( ) 1.02 ( ) ELST present in 7726 (2.2) 4.28 ( ) No ELST present in 27 (1.0) Reference Physician present in 484 (5.2) 1.39 ( ) No physician present in 7269 (2.1) Reference Defibrillation by emergency 4563 (11.7) 3.16 ( ) responder No defibrillation by 3170 (1.0) Reference emergency responder Insertion of intravenous line 1319 (1.8) 1.15 ( ) No insertion of intravenous 6398 (2.3) Reference line Year (1.7) Reference (1.9) 0.86 ( ) (2.3) 1.20 ( ) (2.3) 0.94 ( ) (2.4) 1.05 ( ) (2.4) 1.02 ( ) Abbreviations: OR, odds ratio; CI, confidence interval; VT, ventricular tachycardia; VF, ventricular fibrillation; CPR, cardiopulmonary resuscitation; AED, automated external defibrillator; ELST, emergency lifesaving technician.

5 Favorable Neurological Outcome Among Propensity-Matched Patients a (continued) a Data are expressed as odds ratio (95% confidence interval) unless otherwise indicated. b Selected variables are a predefined set of potential confounders including age, sex, cause of arrest, first documented rhythm, bystander witness, type of CPR initiated by a bystander, use of a public-access automated external defibrillator by bystander, epinephrine administration, and time from receipt of a call to CPR by emergency medical service, and time from receipt of a call to hospital arrival. c All variables included all covariates in Table 1 and variables for 47 prefectures in Japan.