Dissemination of Chest Compression-Only Cardiopulmonary Resuscitation and Survival After Out-of-Hospital Cardiac Arrest
Background—The best cardiopulmonary resuscitation (CPR) technique for survival after out-of-hospital cardiac arrests (OHCAs) has been intensively discussed in the recent few years. However, most analyses focused on comparison at individual level and how well the dissemination of bystander-initiated chest compression-only CPR (CCCPR) increases survival after OHCAs at the population level remains unclear. We therefore evaluated the impact of nationwide dissemination of bystander-initiated CCCPR on the survival after OHCA.
Methods and Results—A nationwide, prospective, population-based observational study covering the whole population of Japan and involving consecutive OHCA patients with resuscitation attempts was conducted from January 2005 through December 2012. The main outcome measure was one-month survival with favorable neurologic outcome. The incidence of survival with favorable neurologic outcome attributed by types of bystander CPR (CCCPR and conventional CPR with rescue breathing) was estimated. Among 816,385 OHCAs before emergency-medical-services arrival, 249,970 (30.6%) received CCCPR, 100,469 (12.3%) conventional CPR, and 465,946 (57.1%) no CPR. The proportion of OHCA patients receiving CCCPR or any CPR (either CCCPR or conventional CPR) by bystanders increased from 17.4% to 39.3% (P for trend <0.001) and 34.6% to 47.3% (P for trend <0.001), respectively. The incidence of survival with favorable neurologic outcome attributed by CCCPR per 10 million population significantly increased from 0.6 to 28.3 (P for trend=0.010), and that by any bystander-initiated CPR significantly increased from 9.0 to 43.6 (P for trend=0.003).
Conclusions—Nationwide dissemination of CCCPR for lay-rescuers was associated with the increase in the incidence of survival with favorable neurologic outcome after OHCAs in Japan.
- cardiac arrest
- cardiopulmonary resuscitation
- death, sudden (if surviving, use heart arrest)
- chest compression resuscitation
- Received December 15, 2014.
- Revision received May 21, 2015.
- Accepted May 28, 2015.