Improved Survival and Increase in Bystander Cardiopulmonary Resuscitation After Outof-Hospital Cardiac Arrest: A Nationwide Cohort Study 2001-2010

Wissenberg, Mads; Folke, Fredrik; Weeke, Peter; Hansen, Carolina Malta; Olesen, Jonas Bjerring; Lindhardsen, Jesper; Lippert, Freddy; Gislason, Gunnar; Nielsen, Soeren L; Køber, Lars; Torp‐Pedersen, Christian

doi:10.1016/s0735-1097(12)61897-x

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“…30-day survival 2. patients who survived to hospital admission Age, sex, the site of cardiac arrest, Increasing delay to defibrillation 13 Lindner(2011) [ 22 ] Stavanger, Norway (2001.01–2008.12) OHCAs (846) Mean 71 Med 8.5 1. ROSC 2. survival to discharge age, year, witnessed status, initial cardiac rhythm, EMS response time 14 Wissenberg(2013) [ 23 ] Denmark (2001–2010) OHCAs (19468) Med 72 Med 11 1. 30-day survival age, sex 15 Nehme(2015) [ 33 ] Victoria, Australian (2002.07–2012.06) OHCAs VT/VF (5561) Med 70 Med 8.0 1. survival to hospital discharge 2. survival to hospital discharge (shockable rhythm) age, sex, year of arrest, witnessed status, initial cardiac rhythm, EMS response time 16 Lai (2015) [ 26 ] Singapore (2001–2004,2010–2012) OHCAs (5453) Mean 62 Med 6.2 1. survival to discharge age, year, witnessed status, initial cardiac rhythm, EMS response time, Mechanical CPR by EMS, prehospital advanced airway, medicine 17 Hasselqvist-Ax(2015) [ 24 ] Sweden (1990.01–2011.12) OHCAs (30381) VT/VF (10094) Med 72 Med 7 1.…”

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confidence: 99%

The effect of bystander cardiopulmonary resuscitation on the survival of out-of-hospital cardiac arrests: a systematic review and meta-analysis

Song

Guo

et al. 2018

Scand J Trauma Resusc Emerg Med

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BackgroundFor many years, bystander cardiopulmonary resuscitation (BCPR) has been considered as a favorable factor to improve survival of out-of-hospital cardiac arrests (OHCAs). To examine the effect of BCPR on the survival of OHCAs and whether BCPR might also improve survival when the initial rhythm of OHCAs is limited, we performed a meta-analysis on published observational studies.MethodsWe did a systematic review to identify all studies published up to March, 2018, in any language, that reported the relation between BCPR and the survival of OHCAs. Using standard forms, two authors independently identified studies for inclusion and extracted information. The outcome was survival. Meta-regression was done to ascertain weighted factors for the outcomes.ResultsData were extracted from 19 studies involving 232,703 patients. Firstly, pooled odds ratio (OR) from 16 cohort studies showed that BCPR was associated with improved chance of survival of OHCAs compared with NO-BCPR (OR 1.95, 95% confidence interval [CI]: 1.66–2.30). Secondly, from 8 cohort studies of OHCAs whose initial rhythm is limited, the pooled OR was 2.10 (95% CI, 1.68–2.63) of 6 articles for shockable rhythm and 1.07 (95% CI, 0.37–3.13) of 2 articles for non-shockable rhythm. Meta-regression showed a relation between the survival of OHCAs and BCPR was influenced by area (p < 0.05).ConclusionsBased on currently available evidence, the findings of this meta-analysis suggest that BCPR increases the survival of OHCAs, and it also help OHCAs whose initial rhythm is shockable. That is to say BCPR is also helpful when emergency department response time is short. Therefore global priority should be given to increasing the incidence of BCPR by evidence-based best practice.

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