Association of response time interval with neurological outcomes after out-of-hospital cardiac arrest according to bystander CPR

Moon, Sungbae; Ryoo, Hyun Wook; Ahn, Jae Yun; Lee, Dong‐Eun; Shin, Sang Do; Park, Jeong Ho

doi:10.1016/j.ajem.2020.05.108

Cited by 16 publications

(8 citation statements)

References 34 publications

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“…Therefore, actively increasing the proportion of bystander CPR in patients with OHCA may improve the prognosis. At the same time, earlier bystander CPR translates to better prognosis, survival, discharge, and neurological recovery [12] . In our study, the vast majority of OHCA occurred at home (74.9%).…”

Section: Discussionsupporting

confidence: 48%

“…Therefore, it is particularly important to start bystander CPR as soon as possible before the arrival of EMS medical staff. One study involving four regions in Asia showed an average time to EMS response of 6 minutes in the analysis of 13,245 OHCA data [12] . The average time for EMS response to collapse location in Beijing in 2013 and 2017 was 15 minutes, with no significant change.…”

Section: Discussionmentioning

confidence: 99%

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Outcome of bystander cardiopulmonary resuscitation after out-of-hospital cardiac arrest in Beijing

Shi

et al. 2021

Emergency and Critical Care Medicine

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Aim: We aimed to investigate the association between bystander cardiopulmonary resuscitation (CPR) and survival of patients with out-of-hospital cardiac arrests (OHCA) in Beijing. Methods: This observational study analyzed adult patients with OHCA treated by the Beijing emergency medical service (EMS) from January 2013 to December 2017. Data were collected in a Utstein style with a 1-year follow-up and a primary outcome of survival to hospital discharge. Secondary outcomes were return of spontaneous circulation (ROSC), survival to admission, favorable neurological outcome at hospital discharge, and survival and favorable neurological outcomes of up to 1 year. Results: A total of 5016 patients with OHCA from Beijing's urban area were recorded by EMS, wherein 765 patients (15.25%) underwent bystander CPR. The data were propensity score-matched forage, sex, location, witness, aetiology, initial rhythm, and call to EMS arrival to compare the difference between the occurrence and nonoccurrence of bystander CPR. The survival upon the discharge of patients who experienced bystander CPR was superior to that of patients who did not receive bystander CPR (3.7% vs 1.2%, respectively; P < 0.001). Moreover, patients with OHCA resuscitated with bystander CPR achieved better outcomes of ROSC, survival to admission, favorable neurological outcome at hospital discharge, survival and favorable neurological outcome after 1 year compared with those who were not resuscitated with bystander CPR. Conclusion: Survival and neurological outcome of patients who underwent bystander CPR was better than those who underwent nonbystander CPR in Beijing. However, the rate of bystander CPR was low.

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Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Outcome of bystander cardiopulmonary resuscitation after out-of-hospital cardiac arrest in Beijing

Shi

et al. 2021

Emergency and Critical Care Medicine

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“…The surge in COVID-19 cases may have led to increased response times in certain regions due to ambulance shortages. Longer response times negatively impact good neurologic outcomes and survival to hospital discharge, but the provision of bystander CPR may offset some of the negative effects of longer response times [ 10 ]. Therefore, emphasis on bystander CPR during COVID-19 outbreaks should be highlighted as well as the critical role of DACPR in initiating and maintaining bystander CPR.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 outbreak on adult out-of-hospital cardiac arrest outcomes in Daegu, South Korea: an observational study

et al. 2021

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Objective This study aimed to compare the outcomes of adult out-of-hospital cardiac arrest (OHCA) before and after the coronavirus disease 2019 (COVID-19) outbreak in a large metropolitan city.Methods This before-and-after observational study used a prospective citywide OHCA registry. Adult patients with emergency medical service-treated OHCA, with presumed cardiac etiology, pre-and post-COVID-19 outbreak were enrolled. The study period spanned 2 months, starting from February 18, 2020. The control period was 2 months from February 18, 2019. The primary and secondary outcomes were good neurologic outcome and survival to hospital discharge, respectively. The association between the COVID-19 outbreak and OHCA outcomes was assessed using multivariable logistic regression analysis. ResultsThis study analyzed 297 OHCA patients (control period, 145; study period, 152). The bystander cardiopulmonary resuscitation rates were 64.8% and 60.5% during the control and study periods, respectively. Response and on-scene times increased by 2 minutes, supraglottic airway use increased by 35.6%, and mechanical chest compression device use increased by 13% post-COVID-19 outbreak. Good neurologic outcome was significantly lower during the study period in overall OHCAs (adjusted odds ratio, 0.23; 95% confidence interval, 0.05-0.98) and in witnessed OHCAs (adjusted odds ratio, 0.14; 95% confidence interval, 0.02-0.90). No significant difference was found in the survival to hospital discharge of OHCA patients between the two periods. ConclusionDuring the COVID-19 pandemic, the response and on-scene times were longer, and good neurologic outcome was significantly lower than that in the control period.

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“…Timely bystander cardiopulmonary resuscitation (BCPR) is vital to improve the survival of patients experiencing out-of-hospital cardiac arrest [ 1 , 2 ]. Although many strategies have been developed [ 3 , 4 ], BCPR is currently insufficient in most emergency medical service (EMS) systems [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Attitude and behavior toward bystander cardiopulmonary resuscitation during COVID-19 outbreak

et al. 2021

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Background Outbreaks of emerging infectious diseases, such as COVID-19, have negative impacts on bystander cardiopulmonary resuscitation (BCPR) for fear of transmission while breaking social distancing rules. The latest guidelines recommend hands-only cardiopulmonary resuscitation (CPR) and facemask use. However, public willingness in this setup remains unknown. Methods A cross-sectional, unrestricted volunteer Internet survey was conducted to assess individuals’ attitudes and behaviors toward performing BCPR, pre-existing CPR training, occupational identity, age group, and gender. The raking method for weights and a regression analysis for the predictors of willingness were performed. Results Among 1,347 eligible respondents, 822 (61%) had negative attitudes toward performing BCPR. Healthcare providers (HCPs) and those with pre-existing CPR training had fewer negative attitudes (p < 0.001); HCPs and those with pre-existing CPR training and unchanged attitude showed more positive behaviors toward BCPR (p < 0.001). Further, 9.7% of the respondents would absolutely refuse to perform BCPR. In contrast, 16.9% would perform BCPR directly despite the outbreak. Approximately 9.9% would perform it if they were instructed, 23.5%, if they wore facemasks, and 40.1%, if they were to perform hands-only CPR. Interestingly, among the 822 respondents with negative attitudes, over 85% still tended to perform BCPR in the abovementioned situations. The weighted analysis showed similar results. The adjusted predictors for lower negative attitudes toward BCPR were younger age, being a man, and being an HCP; those for more positive behaviors were younger age and being an HCP. Conclusions Outbreaks of emerging infectious diseases, such as COVID-19, have negative impacts on attitudes and behaviors toward BCPR. Younger individuals, men, HCPs, and those with pre-existing CPR training tended to show fewer negative attitudes and behaviors. Meanwhile, most individuals with negative attitudes still expressed positive behaviors under safer measures such as facemask protection, hands-only CPR, and available dispatch instructions.

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Association of response time interval with neurological outcomes after out-of-hospital cardiac arrest according to bystander CPR

Cited by 16 publications

References 34 publications

Outcome of bystander cardiopulmonary resuscitation after out-of-hospital cardiac arrest in Beijing

Outcome of bystander cardiopulmonary resuscitation after out-of-hospital cardiac arrest in Beijing

Impact of the COVID-19 outbreak on adult out-of-hospital cardiac arrest outcomes in Daegu, South Korea: an observational study

Attitude and behavior toward bystander cardiopulmonary resuscitation during COVID-19 outbreak

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