Association of initial rhythm with neurologically favorable survival in non-shockable out-of-hospital cardiac arrest without a bystander witness or bystander cardiopulmonary resuscitation.

•We compared PEA with Asystole in cases without bystander witness or bystander CPR.•Neurological outcome was more favorable in PEA than in Asystole.•Neurologically favorable survival rate was ≥1% in PEA even for patients aged ≥85years.•Neurologically favorable survival rate was <1% in Asystole among all age groups.•PEA and Asystole should be distinguished from the perspective of medical futility.