Abstract 19085: Outcomes After Cardiopulmonary resuscitation With Chest Compressions Only versus Conventional CPR: A Meta-Analysis of 84,888 Patients
Objectives: Optimal method of by-stander cardiopulmonary resuscitation (CPR) is still controversial. Studies comparing “chest compressions only CPR” with “conventional CPR” have yielded mixed results. We intended to compare the effectiveness of the above two strategies on survival after cardiac arrest out of hospital by performing a meta-analysis of all available clinical studies till date.
Methods: We searched Medline and Embase for randomized control trials (RCT) and prospective observational studies comparing “chest compressions only CPR” with “conventional CPR”. Only studies presenting survival outcomes were included. Random effects model with inverse variance weighting was used to calculate pooled risk ratio (RR). Subgroup analyses were also performed as deemed necessary.
Results: We identified 15 studies (12 observational and 3 RCTs) including 84,888 patients, of whom 39,572 received chest compressions only and 45,316 received conventional CPR. There was no significant difference in the survival with either technique (RR: 1.08; 0.93 - 1.26, p = 0.33). Exclusion of one study which reported only neurologically favorable survival did not alter the composite analysis. There was a significant heterogeneity among the studies (I2 = 85%, p<0.001). Begg’s and Egger’s regression test did not reveal any publication bias. Sub-group analyses of observational studies (RR: 0.97; 0.85-1.12, p=0.71) and RCTs (RR: 1.6; 0.88 - 3.1, p =0.12) did not demonstrate any difference in the survival outcome between the two techniques.
Conclusion: By-stander “chest compressions-only CPR” is associated with similar survival rate when compared to “conventional CPR”.
- © 2013 by American Heart Association, Inc.