Comparison between dispatcher-assisted bystander CPR and self-led bystander CPR in out-of-hospital cardiac arrest (OHCA). (January 2021)

• Record Type: Journal Article
• Authors: Kim, Min Woo; Kim, Tae Han; Song, Kyoung Jun; Shin, Sang Do; Kim, Chu Hyun; Lee, Eui Jung; Kim, Kihong
• Is Part Of: Resuscitation. Volume 158(2021)
• Page Start: 64
• Page End: 70
• Publication Date: 2021-01
• Subjects: Out-of-hospital cardiac arrest -- Bystander cardiopulmonary resuscitation -- Dispatcher-assisted cardiopulmonary resuscitation; Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2020.11.010
• Languages: English
• ISSNs: 0300-9572

Abstract

Abstract: Introduction: Bystander cardiopulmonary resuscitation (CPR) is an important prognostic factor for outcome in out-of-hospital cardiac arrest (OHCA). The dispatcher-assisted (DA) bystander CPR program has increased the rate of bystander CPR by targeting bystanders with a lower level of CPR training. We evaluated the effects of dispatcher-assisted bystander CPR and self-led bystander CPR. Methods: A retrospective analysis was performed using a nationwide OHCA database from 2014 to 2018. Adult EMS-treated OHCA patients with presumed cardiac origin were enrolled. OHCAs were classified into 3 groups according to the type of bystander CPR (DA bystander CPR vs. self-led bystander CPR vs. no bystander CPR) provided. The primary outcome was good neurologic recovery at hospital discharge. A multivariable logistic regression model was used to estimate the association between the type of bystander CPR and outcomes. Results: A total of 91, 557 eligible OHCA patients was enrolled in the final analysis. The proportion of patients with favorable neurologic outcomes was highest with self-led bystander CPR (9.0% for self-led bystander CPR, 5.2% for DA bystander CPR and 3.2% for no bystander CPR, p < 0.01). Self-led bystander CPR was associated with better neurological recovery than DA bystander CPR (aOR with 95% CI (DA-CPR as reference): 0.63 (0.58−0.69) for no bystander CPR, 1.28 (1.17–1.40) for self-led bystander CPR). Conclusion: Although DA CPR was associated with better neurologic outcomes than no bystander CPR, good neurologic outcomes were most strongly associated with self-led bystander CPR.