Association of Bystander Cardiopulmonary Resuscitation and Survival According to Ambulance Response Times After Out-of-Hospital Cardiac Arrest
Authors' conclusion
The absolute survival associated with bystander CPR declined rapidly with time. Yet bystander CPR while waiting for an ambulance was associated with a more than doubling of 30-day survival even in case of long ambulance response time.
Study context
- Population
- OHCA patients, nationwide Danish Cardiac Arrest Registry, 2005–2011
- Participants
- 7,623 patients
- Exposure
- Bystander cardiopulmonary resuscitation (CPR) vs no bystander CPR, by ambulance response time
- Outcome
- Association of bystander CPR with survival as time to advanced treatment increases
- Follow-up
- 30 days
Methodological detailsnationwide, multiple logistic regression
- Nationwide
- Multiple logistic regression
Main finding
As reported in the abstract
30-day survival
| Group | Response within 5 min | Response within 10 min | Response >13 min |
|---|---|---|---|
| Bystander CPR | 14.5% (95% CI: 12.8-16.4) | 6.7% (95% CI: 5.4-8.1) | 3.7% [95% CI: 2.2-5.4] |
| No bystander CPR | 6.3% (95% CI: 5.1-7.6) | 2.2% (95% CI: 1.5-3.1) | 1.5% [95% CI: 0.6-2.7] |
Response within 5 min
Bystander CPR14.5% (95% CI: 12.8-16.4)
No bystander CPR6.3% (95% CI: 5.1-7.6)
Response within 10 min
Bystander CPR6.7% (95% CI: 5.4-8.1)
No bystander CPR2.2% (95% CI: 1.5-3.1)
Response >13 min
Bystander CPR3.7% [95% CI: 2.2-5.4]
No bystander CPR1.5% [95% CI: 0.6-2.7]
- Survival chances higher with bystander CPR, response within 5 min
- 2.3 times
- Survival chances higher with bystander CPR, response within 10 min
- 3.0 times
- Survival higher with bystander CPR, response >13 min (contrast statistically insignificant)
- 2.5 times
Observational data: associations, not effects.
Further findings
Modelled additional patients potentially saved annually (Denmark)
- Response time reduced from 10 to 5 min
- 233
- Response time reduced from 7 (median) to 5 min
- 119
Original publication
Association of Bystander Cardiopulmonary Resuscitation and Survival According to Ambulance Response Times After Out-of-Hospital Cardiac Arrest. Circulation. Published 22 November 2016. doi:10.
Summarised from the published abstract; every number is checked against it