Dispatcher-assisted bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest

Akihito Hagihara, Daisuke Onozuka, Hidetoshi Shibuta, Manabu Hasegawa, Takashi Nagata

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Bystander cardiopulmonary resuscitation (CPR) is critical to the survival of patients with out-of-hospital cardiac arrest (OHCA). However, it is unknown whether bystander CPR with or without dispatcher assistance is more effective or why. Thus, we evaluated the association between dispatcher-assisted bystander CPR (vs. bystander CPR without dispatcher assistance) and survival of patients with OHCA.

METHODS: This is a retrospective, nonrandomized, observational study using national registry data for all OHCAs. We performed a propensity analysis. Patients with OHCA of cardiac origin were 18-100 years of age and received bystander chest compression in Japan between 2005 and 2014. Outcome measures were bystander rescue breathing, return of spontaneous circulation (ROSC) before hospital arrival, and survival and Cerebral Performance Category (CPC) 1 or 2 at 1 month after the event.

RESULTS: During the study period, 1,176,351 OHCAs occurred, and 87,400 cases met the inclusion criteria. Among propensity-matched patients, a negative association was observed between dispatcher-assisted bystander CPR and outcome measures in a fully-adjusted model [odds ratio (OR) (95% CI) for ROSC = 0.87 (0.78-0.97), P < 0.05; OR (95% CI) for 1-month survival = 0.81 (0.65-1.00), P < 0.05; OR (95% CI) for CPC 1 or 2 = 0.64 (0.43-0.93), P < 0.05]. OR of survival for dispatcher-assisted bystander CPR tended to decrease as the emergency medical services response time increased.

CONCLUSIONS: Survival benefit was less for dispatcher-assisted bystander CPR with dispatcher assistance than without dispatcher assistance. Low quality is hypothesized to be the cause of the reduced benefit.

Original languageEnglish
JournalInternational Journal of Cardiology
DOIs
Publication statusE-pub ahead of print - Apr 19 2018

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Out-of-Hospital Cardiac Arrest
Cardiopulmonary Resuscitation
Survival
Odds Ratio
Outcome Assessment (Health Care)
Emergency Medical Services
Reaction Time
Observational Studies
Registries
Japan
Respiration
Thorax

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Dispatcher-assisted bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest. / Hagihara, Akihito; Onozuka, Daisuke; Shibuta, Hidetoshi; Hasegawa, Manabu; Nagata, Takashi.

In: International Journal of Cardiology, 19.04.2018.

Research output: Contribution to journalArticle

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title = "Dispatcher-assisted bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest",
abstract = "INTRODUCTION: Bystander cardiopulmonary resuscitation (CPR) is critical to the survival of patients with out-of-hospital cardiac arrest (OHCA). However, it is unknown whether bystander CPR with or without dispatcher assistance is more effective or why. Thus, we evaluated the association between dispatcher-assisted bystander CPR (vs. bystander CPR without dispatcher assistance) and survival of patients with OHCA.METHODS: This is a retrospective, nonrandomized, observational study using national registry data for all OHCAs. We performed a propensity analysis. Patients with OHCA of cardiac origin were 18-100 years of age and received bystander chest compression in Japan between 2005 and 2014. Outcome measures were bystander rescue breathing, return of spontaneous circulation (ROSC) before hospital arrival, and survival and Cerebral Performance Category (CPC) 1 or 2 at 1 month after the event.RESULTS: During the study period, 1,176,351 OHCAs occurred, and 87,400 cases met the inclusion criteria. Among propensity-matched patients, a negative association was observed between dispatcher-assisted bystander CPR and outcome measures in a fully-adjusted model [odds ratio (OR) (95{\%} CI) for ROSC = 0.87 (0.78-0.97), P < 0.05; OR (95{\%} CI) for 1-month survival = 0.81 (0.65-1.00), P < 0.05; OR (95{\%} CI) for CPC 1 or 2 = 0.64 (0.43-0.93), P < 0.05]. OR of survival for dispatcher-assisted bystander CPR tended to decrease as the emergency medical services response time increased.CONCLUSIONS: Survival benefit was less for dispatcher-assisted bystander CPR with dispatcher assistance than without dispatcher assistance. Low quality is hypothesized to be the cause of the reduced benefit.",
author = "Akihito Hagihara and Daisuke Onozuka and Hidetoshi Shibuta and Manabu Hasegawa and Takashi Nagata",
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T1 - Dispatcher-assisted bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest

AU - Hagihara, Akihito

AU - Onozuka, Daisuke

AU - Shibuta, Hidetoshi

AU - Hasegawa, Manabu

AU - Nagata, Takashi

N1 - Copyright © 2017 Elsevier B.V. All rights reserved.

PY - 2018/4/19

Y1 - 2018/4/19

N2 - INTRODUCTION: Bystander cardiopulmonary resuscitation (CPR) is critical to the survival of patients with out-of-hospital cardiac arrest (OHCA). However, it is unknown whether bystander CPR with or without dispatcher assistance is more effective or why. Thus, we evaluated the association between dispatcher-assisted bystander CPR (vs. bystander CPR without dispatcher assistance) and survival of patients with OHCA.METHODS: This is a retrospective, nonrandomized, observational study using national registry data for all OHCAs. We performed a propensity analysis. Patients with OHCA of cardiac origin were 18-100 years of age and received bystander chest compression in Japan between 2005 and 2014. Outcome measures were bystander rescue breathing, return of spontaneous circulation (ROSC) before hospital arrival, and survival and Cerebral Performance Category (CPC) 1 or 2 at 1 month after the event.RESULTS: During the study period, 1,176,351 OHCAs occurred, and 87,400 cases met the inclusion criteria. Among propensity-matched patients, a negative association was observed between dispatcher-assisted bystander CPR and outcome measures in a fully-adjusted model [odds ratio (OR) (95% CI) for ROSC = 0.87 (0.78-0.97), P < 0.05; OR (95% CI) for 1-month survival = 0.81 (0.65-1.00), P < 0.05; OR (95% CI) for CPC 1 or 2 = 0.64 (0.43-0.93), P < 0.05]. OR of survival for dispatcher-assisted bystander CPR tended to decrease as the emergency medical services response time increased.CONCLUSIONS: Survival benefit was less for dispatcher-assisted bystander CPR with dispatcher assistance than without dispatcher assistance. Low quality is hypothesized to be the cause of the reduced benefit.

AB - INTRODUCTION: Bystander cardiopulmonary resuscitation (CPR) is critical to the survival of patients with out-of-hospital cardiac arrest (OHCA). However, it is unknown whether bystander CPR with or without dispatcher assistance is more effective or why. Thus, we evaluated the association between dispatcher-assisted bystander CPR (vs. bystander CPR without dispatcher assistance) and survival of patients with OHCA.METHODS: This is a retrospective, nonrandomized, observational study using national registry data for all OHCAs. We performed a propensity analysis. Patients with OHCA of cardiac origin were 18-100 years of age and received bystander chest compression in Japan between 2005 and 2014. Outcome measures were bystander rescue breathing, return of spontaneous circulation (ROSC) before hospital arrival, and survival and Cerebral Performance Category (CPC) 1 or 2 at 1 month after the event.RESULTS: During the study period, 1,176,351 OHCAs occurred, and 87,400 cases met the inclusion criteria. Among propensity-matched patients, a negative association was observed between dispatcher-assisted bystander CPR and outcome measures in a fully-adjusted model [odds ratio (OR) (95% CI) for ROSC = 0.87 (0.78-0.97), P < 0.05; OR (95% CI) for 1-month survival = 0.81 (0.65-1.00), P < 0.05; OR (95% CI) for CPC 1 or 2 = 0.64 (0.43-0.93), P < 0.05]. OR of survival for dispatcher-assisted bystander CPR tended to decrease as the emergency medical services response time increased.CONCLUSIONS: Survival benefit was less for dispatcher-assisted bystander CPR with dispatcher assistance than without dispatcher assistance. Low quality is hypothesized to be the cause of the reduced benefit.

U2 - 10.1016/j.ijcard.2018.04.067

DO - 10.1016/j.ijcard.2018.04.067

M3 - Article

C2 - 29703565

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -