Trend in survival after out-of-hospital cardiac arrest and its relationship with bystander cardiopulmonary resuscitation: a six-year prospective observational study in Beijing

Chen, Yuling; Yue, Peng; Wu, Ying; Li, Jia; Lei, Yanni; Ding, Guanghong; Liu, Jiang; Han, Pengda

doi:10.1186/s12872-021-02446-z

Cited by 13 publications

(13 citation statements)

References 42 publications

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“…Heterogeneity: research designs and provide more reliable results [4,20,21]. Therefore, the actual survival outcomes in China may be lower than that of our pooled results.…”

Section: Random Effects Modelmentioning

confidence: 81%

“…Moreover, our subgroup analysis found that survival rates were affected by the number of participants in our meta-analysis, and the group with participants more than 500 was lower than that of group with participants less than 500. Large sample studies usually have better research designs and provide more reliable results [ 4 , 20 , 21 ]. Therefore, the actual survival outcomes in China may be lower than that of our pooled results.…”

Section: Discussionmentioning

confidence: 99%

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Survival outcome among patients with out-of-hospital cardiac arrest who received cardiopulmonary resuscitation in China: a systematic review and meta-analysis

et al. 2023

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Background This study aimed to assess the survival outcomes among patients with out-of-hospital cardiac arrest (CA) who received cardiopulmonary resuscitation (CPR) in China. Methods Relevant studies, published between January 1, 2010 and September 5, 2022, were retrieved from databases, including EMBASE, PubMed, Cochrane Library, the China Biology Medicine disk, China National Knowledge Infrastructure, and Wanfang databases. We included clinical studies in which all patients were diagnosed with CA and underwent out-of-hospital CPR, and the outcome variables were at least one of the following: return of spontaneous circulation (ROSC), survival to admission, survival to hospital discharge, 1-month survival, achieved good neurological outcomes, and 1-year survival. Two investigators independently extracted the study data and assessed its quality using a modified Newcastle–Ottawa Scale tool. The data were pooled using random-effects models. Results Of the 3620 identified studies, 49 (63,378 patients) were included in the meta-analysis. The pooled ROSC rate was 9.0% (95% confidence interval [CI] 7.5–10.5%, I2 = 97%), the pooled survival to admission rate was 5.0% (95% CI 2.7–8.0%, I2 = 98%), and the pooled survival to discharge rate was 1.8% (95% CI 1.2–2.5%, I2 = 95%). Additionally, the ROSC rate of patients with bystander CPR was significantly higher than that of those without bystander CPR, and the pooled odds ratio (OR) was 7.92 (95% CI 4.32–14.53, I2 = 85%). The ROSC rate of participants who started CPR within 5 min was significantly higher than that of those who started CPR after 5 min, and the pooled OR was 5.92 (95% CI 1.92–18.26, I2 = 85%). The ROSC rate of participants with defibrillation was significantly higher than that of those without defibrillation, and the pooled OR was 8.52 (95% CI 3.72–19.52, I2 = 77%). Conclusion The survival outcomes of out-of-hospital CPR in China are far below the world average. Therefore, the policy of providing automated external defibrillators (AEDs) in public places and strengthening CPR training for healthcare providers and public personnel should be encouraged and disseminated nationwide. Trial registration This study was registered in PROSPERO (CRD42022326165) on 29 April 2022.

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“…Heterogeneity: research designs and provide more reliable results [4,20,21]. Therefore, the actual survival outcomes in China may be lower than that of our pooled results.…”

Section: Random Effects Modelmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Survival outcome among patients with out-of-hospital cardiac arrest who received cardiopulmonary resuscitation in China: a systematic review and meta-analysis

et al. 2023

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“…The rate of bystander CPR in China is less than 20%. Most victims received appropriate treatment only when EMS personnel arrived at the scene[ 15 ]. In the large cities of China, the average time from the emergency call to EMS arrival was 10 minutes[ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Correlation between the warning symptoms and prognosis of cardiac arrest

Kang¹,

Bai²,

Zhai³

et al. 2022

WJCC

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BACKGROUND A low survival rate in patients with cardiac arrest is associated with failure to recognize the condition in its initial stage. Therefore, recognizing the warning symptoms of cardiac arrest in the early stage may play an important role in survival. AIM To investigate the warning symptoms of cardiac arrest and to determine the correlation between the symptoms and outcomes. METHODS We included all adult patients with all-cause cardiac arrest who visited Peking University Third Hospital or Beijing Friendship Hospital between January 2012 and December 2014. Data on population, symptoms, resuscitation parameters, and outcomes were analysed. RESULTS Of the 1021 patients in the study, 65.9% had symptoms that presented before cardiac arrest, 25.2% achieved restoration of spontaneous circulation (ROSC), and 7.2% survived to discharge. The patients with symptoms had higher rates of an initial shockable rhythm (12.2% vs 7.5%, P = 0.020), ROSC (29.1% vs 17.5%, P = 0.001) and survival (9.2% vs 2.6%, P = 0.001) than patients without symptoms. Compared with the out-of-hospital cardiac arrest (OHCA) without symptoms subgroup, the OHCA with symptoms subgroup had a higher rate of calls before arrest (81.6% vs 0.0%, P < 0.001), health care provider-witnessed arrest (13.0% vs 1.4%, P = 0.001) and bystander cardiopulmonary resuscitation (15.5% vs 4.9%, P = 0.002); a shorter no flow time (11.7% vs 2.8%, P = 0.002); and a higher ROSC rate (23.8% vs 13.2%, P = 0.011). Compared to the in-hospital cardiac arrest (IHCA) without symptoms subgroup, the IHCA with symptoms subgroup had a higher mean age (66.2 ± 15.2 vs 62.5 ± 16.3 years, P = 0.005), ROSC (32.0% vs 20.6%, P = 0.003), and survival rates (10.6% vs 2.5%, P < 0.001). The top five warning symptoms were dyspnea (48.7%), chest pain (18.3%), unconsciousness (15.2%), paralysis (4.3%), and vomiting (4.0%). Chest pain (20.9% vs 12.7%, P = 0.011), cardiac etiology (44.3% vs 1.5%, P < 0.001) and survival (33.9% vs 16.7%, P = 0.001) were more common in males, whereas dyspnea (54.9% vs 45.9%, P = 0.029) and a non-cardiac etiology (53.3% vs 41.7%, ...

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“…Thus, bystander first-aid is a medical intervention behaviour in which the eyewitness initiates CPR before professional medical staff arrival, shortening the treatment time and improving treatment effects [10]. Besides, some studies reported that emergency response time, emergency telephone availability, patients' initial heart rhythm type, and out-of-hospital defibrillation are key factors that increase the survival rate [1,9,[11][12][13]. In addition, the composition of prehospital emergency physicians may be another critical issue.…”

Section: Introductionmentioning

confidence: 99%

A retrospective study on epidemiological analysis of pre-hospital emergency care in Hangzhou, China

Wang¹,

Chen³

et al. 2023

PLoS ONE

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Out-of-hospital cardiac arrest (OHCA) is a leading cause of global mortality, with numerous factors influencing the patient survival rate and prognosis. This study aimed to evaluate the OHCA epidemiology in China and elaborate on the current Hangzhou emergency system status. This retrospective analysis was based on the medical history system of the Hangzhou Emergency Center registered from 2015–2021. We provided a detailed description of OHCA characteristics and investigated the factors affecting the success rate of emergency treatment in terms of epidemiology, causes of onset, bystander rescue, and outcome factors. We included 9585 out-of-hospital cardiac arrest cases, of which 5442 (56.8%) had evidence of resuscitation. Patients with underlying diseases constituted the vast majority (80.1%); trauma and physicochemical factors accounted for 16.5% and 3.4%, respectively. Only 30.4% of patients (about 80.0% of bystanders witnessed) received bystander first aid. The outcome rate of emergency doctors dispatched by emergency centres was significantly higher than doctors dispatched by hospitals. Additionally, physician’s first-aid experience, emergency response time, emergency telephone availability, initial heart rhythm, out-of-hospital defibrillation, out-of-hospital intubation, and using of epinephrine significantly can significantly improve the out-of-hospital return of spontaneous circulation in patients. All steps in pre-hospital care are important for patients, especially for bystander first aid and physician’s first-aid experience. The popularity of first-aid training and the public emergency medical system are not potent enough. We should take those key factors into consideration when developing a pre-hospital care system for OHCA.

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Trend in survival after out-of-hospital cardiac arrest and its relationship with bystander cardiopulmonary resuscitation: a six-year prospective observational study in Beijing

Cited by 13 publications

References 42 publications

Survival outcome among patients with out-of-hospital cardiac arrest who received cardiopulmonary resuscitation in China: a systematic review and meta-analysis

Survival outcome among patients with out-of-hospital cardiac arrest who received cardiopulmonary resuscitation in China: a systematic review and meta-analysis

Correlation between the warning symptoms and prognosis of cardiac arrest

A retrospective study on epidemiological analysis of pre-hospital emergency care in Hangzhou, China

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