Acute cardiac care & resuscitation
Time to bystander cardiopulmonary resuscitation (CPR) and survival for witnessed out-of-hospital cardiac arrest
Authors' conclusion
Compared with no bystander CPR, bystander CPR was associated with improved survival even when started at 8 to 9 min. Given that there is a graded, inverse relationship between time to bystander CPR and survival, these findings underscore the urgency of immediate bystander CPR initiation to optimize OHCA survival.
Study context
- Population
- Witnessed out-of-hospital cardiac arrests (out-of-hospital cardiac arrest (OHCAs)) in the Cardiac Arrest Registry to Enhance Survival, 2013–2023
- Participants
- 194,807 witnessed OHCAs
- Exposure
- Each time interval for initiation of bystander CPR (0-1, 2-3, 4-5, 6-7, 8-9, 10 + minutes), compared with no bystander CPR
- Outcome
- Survival to discharge
Main finding
As reported in the abstract
Each group vs no bystander CPROdds ratio (95% CI)
0-1 min
1.78(1.73–1.84)
2-3 min
1.57(1.51–1.64)
4-5 min
1.23(1.17–1.30)
6-7 min
1.25(1.15–1.35)
8-9 min
1.13(1.03–1.25)
≥ 10 minno survival association was seen at ≥ 10 min
0.80(0.74–0.86)
Observational data: associations, not effects.
Further findings
Favorable neurological survival
- A similar pattern was observed for neurological survival
Cohort characteristics
- Mean age
- 64.4 ± 15.9 years
- Female
- 33.8%
- Bystander CPR provided
- 48.4%
- Median initiation time
- 2 min (IQR: 1-5)
- Survived to discharge (overall)
- 15.3%
- Favorable neurological survival (overall)
- 12.9%
Original publication
Time to bystander CPR and survival for witnessed out-of-hospital cardiac arrest. Resuscitation. Published 25 February 2025. doi:10.
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