Abstract 300: Predominant Effect of Conventional Bystander CPR Without Dispatcher-Assisted Instruction on Survival from Out-of-Hospital Cardiac Arrests in Remote Time-Distance Region
Aim: To identify the factors associated with survival from bystander-witnessed out-of-hospital cardiac arrests (OHCAs) in remote time-distance region.
Methods: Cleaned data for 193,914 bystander-witnessed OHCAs without any prehospital physician involvement were extracted from those for 716,608 OHCAs collected prospectively between 2007 and 2012 in Japan. Of these OHCAs, 17,209 cases having a response time (call[[Unable to Display Character: ‒]]arrival) interval of >13 min were defined as OHCAs in remote region and analyzed for factors associated with one-month neurologically favorable survival.
Results: The rates of bystander CPR (BCPR) and dispatcher-assisted CPR (DA-CPR) in the remote region (52.2 and 45.3%, respectively) were slightly higher than those in the other regions (45.9 and 44.2%). However, the survival rate in this region (1.1%, odds ratio; 95% CI, 0.24; 0.21-0.28) was much lower than that in other regions (4.3%, reference). When BCPR was classified into five groups, the survival rate in remote region was 0.6, 1.0, 1.6, 1.6 and 2.9% for no BCPR (N=8,231), compression-only BCPR following DA-CPR (N=4.321), conventional (compression + ventilation) BCPR following DA-CPR (N=1,492), compression-only BCPR without DA-CPR (N=1.990) and conventional BCPR without DA-CPR (N=1,175), respectively. After adjustment for other factors associated with outcomes, odds ratio (95% confidence interval) for survival with the conventional BCPR without DA-CPR group as reference was 0.25 (0.16[[Unable to Display Character: ‒]]0.40), 0.33 (0.21[[Unable to Display Character: ‒]]0.54), 0.54 (0.31[[Unable to Display Character: ‒]]0.92) and 0.51 (0.30[[Unable to Display Character: ‒]]0.85) for no BCPR, compression-only BCPR following DA-CPR, conventional BCPR following DA-CPR, compression-only BCPR without DA-CPR group, respectively.
Conclusions: Conventional BCPR on bystander’s own initiative (without DA-CPR) has predominant effect on survival from OHCAs in remote time-distance region.
Author Disclosures: Y. Takei: None. T. Nishi: None. T. Kamikura: None. H. Matsubara: None. Y. Wato: None. K. Ohta: None. H. Inaba: None.
- © 2014 by American Heart Association, Inc.