Abstract 19911: Bystander Cardiopulmonary Resuscitation and Bystander Defibrillation Associated With Increased Return to Work in Out-of-Hospital Cardiac Arrest Survivors
Introduction: Early defibrillation holds potential to improve survival following out-of-hospital cardiac arrest (OHCA). However, its association with return to work remains unknown.
Methods: Using nationwide data, we examined associations between bystander interventions (cardiopulmonary resuscitation [CPR] alone and defibrillation with and without bystander CPR) and return to work in 30-day survivors of OHCA in Denmark from 2001-2012. We included patients of presumed cardiac etiology, non-EMS-witnessed arrest, of working age (18-65 years) and previously employed in a five-week span prior to OHCA. Employment data was available from the Danish Labor Market Authority database containing weekly follow-up data on employment status since 1991.
Results: Of 665 eligible 30-day survivors, 19.3% (n=128) had not received bystander interventions, 12.9% (n=86) had missing status on bystander interventions, 59.2% (n=394) had received bystander CPR but not bystander defibrillation and 8.6% (n=57) were defibrillated by bystanders. Of 57 patients defibrillated by bystanders, 54 (94.7%) had also received bystander CPR. Relative to the no bystander resuscitation group, patients who received bystander CPR or defibrillation or had missing status on bystander interventions were more often older (P=0.01); men (P=0.008); of higher socioeconomic status (P=0.04); with public location of arrest (P<0.001) and witnessed arrest (P=0.02). In adjusted analyses, bystander CPR and bystander defibrillation were significantly associated with return to work (HR 1.46 [95% CI 1.14-1.87]; and HR 1.58 [95% CI 1.10-2.29], respectively). The cumulative incidence rates of return to work according to bystander intervention status are shown in the Figure.
Conclusion: Bystander CPR and bystander defibrillation were associated with increased return to work rates, suggesting a need for strategies to improve bystander CPR and public access defibrillation to further improve outcomes.
Author Disclosures: O. Dorosh: None. K. Fonager: None. R.N. Mortensen: None. M. Wissenberg: Research Grant; Significant; The Danish Foundation TrygFonden, The Danish Heart Association, The Health Insurance Foundation. S.M. Hansen: Research Grant; Significant; The Danish Foundation TrygFonden, The Danish Heart Foundation. C.M. Hansen: Research Grant; Significant; The Laerdal Foundation, The Danish Heart Foundation, Helse Fonden. S. Rajan: Research Grant; Significant; The Danish Foundation TrygFonden. F. Lippert: None. F. Folke: None. S. Riddersholm: None. G. Gislason: Research Grant; Significant; Novo Nordisk Foundation, Bristol-Myers Squibb, Pfizer, Boehringer Ingelheim, AstraZeneca, Bayer. B.S. Rasmussen: None. S.E. Jensen: None. C. Torp-Pedersen: Research Grant; Significant; Bristol-Myers Squibb. Consultant/Advisory Board; Significant; Cardiome, Merck, Sanofi, Daiichi. K. Kragholm: Research Grant; Significant; The Laerdal Foundation.
- © 2016 by American Heart Association, Inc.