Acute cardiac care & resuscitation
Clinical outcomes following out-of-hospital cardiac arrest: The minute-by-minute impact of bystander cardiopulmonary resuscitation
Authors' conclusion
Although bystander CPR is associated with an immediate increase in odds of survival and of good neurologic outcome for OHCA patients, it does not influence the negative association between longer EMS response time and survival and good neurologic outcome.
Study context
- Population
- Adults with bystander-witnessed out-of-hospital cardiac arrest (OHCA) treated by emergency medical service (EMS) (Resuscitation Outcomes Consortium Cardiac Epidemiologic Registries)of 229,637 screened
- Participants
- 41,012 adults
- Exposure
- Bystander cardiopulmonary resuscitation (CPR) vs no bystander CPR; EMS response time
- Bystander CPRn = 22,145
- No bystander CPRn = 18,867reference
- Outcome
- Survival to hospital discharge
Methodological detailsregistry-based, Multivariable logistic regression
- Registry-based
- Multivariable logistic regression
Main finding
As reported in the abstract
Adjusted odds ratio (95% CI)P value
Bystander CPR vs No bystander CPR
1.70(1.61–1.80)
Each additional minute of EMS response time
0.92(0.91–0.93)
P < 0.001- No interaction between bystander CPR and EMS response time
- P = 0.12
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Adjusted OR (95% CI) | P value | |
|---|---|---|---|
| Survival with good neurologic outcome (modified Rankin scale 0-2)Bystander CPR vs No bystander CPR | 1.87 (1.70–2.06) | ||
| Survival with good neurologic outcome (modified Rankin scale 0-2)Each additional minute of EMS response time | 0.88 (0.86–0.89) | P < 0.001 | |
| 0.512Adjusted odds ratio (log scale) |
- Survival with good neurologic outcome (modified Rankin scale 0-2) — No interaction between bystander CPR and EMS response time
- p = 0.65
- Survival with good neurologic outcome (modified Rankin scale 0-2): interaction p = 0.65
Original publication
Clinical outcomes following out-of-hospital cardiac arrest: The minute-by-minute impact of bystander cardiopulmonary resuscitation. Resuscitation. Published 13 January 2023. doi:10.
Summarised from the published abstract; every number is checked against it