Cardiopulmonary resuscitation performed by off-duty medical professionals versus laypersons and survival from out-of-hospital cardiac arrest among adult patients. (February 2019)

• Record Type: Journal Article
• Authors: Kobayashi, Daisuke; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Nishiyama, Chika; Hayashida, Sumito; Matsuyama, Tasuku; Katayama, Yusuke; Shimamoto, Tomonari; Kiguchi, Takeyuki; Okabayashi, Satoe; Kawamura, Takashi; Iwami, Taku
• Is Part Of: Resuscitation. Volume 135(2019)
• Page Start: 66
• Page End: 72
• Publication Date: 2019-02
• Subjects: Out-of-hospital cardiac arrest -- Cardiopulmonary resuscitation -- Bystander -- Outcome; Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2019.01.005
• Languages: English
• ISSNs: 0300-9572

Abstract

Abstract: Background: Cardiopulmonary resuscitation (CPR) performed by bystanders is a key factor for out-of-hospital cardiac arrest (OHCA) survival. This study aimed to evaluate the relationship between CPR performed by off-duty medical professionals vs. laypersons and one-month survival with favorable neurological outcome after OHCA. Methods: Using a population-based database of OHCA patients in Osaka City, Japan, from 2013 through 2015, we enrolled adult OHCA patients with resuscitation attempts performed by bystanders before the arrival of emergency-medical-service personnel. Multivariable logistic regression analysis was performed to assess the association between CPR performed by off-duty medical professionals vs. laypersons and the OHCA outcome after adjusting for potential confounding factors. The primary outcome measure was one-month survival with favorable neurological outcome, defined as cerebral performance category of 1 or 2. Results: A total of 2326 subjects were eligible for our study. Among these, 365 (15.7%) patients received CPR by off-duty medical professionals and 1, 961 (84.3%) received CPR by laypersons. In the multivariable analysis, there was no difference in favorable neurological outcome between off-duty medical professionals (6.3% [23/365]) and laypersons (5.1% [100/1, 961]) among eligible patients (adjusted odds ratio 0.83, 95% confidence interval [0.37–2.06]). This finding was also confirmed in propensity score-matched patients. Conclusions: In Japan where the CPR training or bystander CPR has been widely disseminating, CPR by laypersons had similar effects compared to that by off-duty medical professionals. As this study could not assess the quality of bystander CPR, further studies are essential to verify the effects of the bystander CPR type on OHCA patients.