Zhixin Wu1, Micah Panczyk2, Daniel W Spaite3, Chengcheng Hu4, Hidetada Fukushima5, Blake Langlais6, John Sutter7, Bentley J Bobrow8. 1. Department of Emergency and Critical Care Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan City, Guangdong Province, China. 2. Bureau of EMS & Trauma System, Arizona Department of Health Services, Phoenix, AZ, United States. Electronic address: micah.panczyk@azdhs.gov. 3. Arizona Emergency Medicine Research Center, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, United States. 4. Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States. 5. Department of Emergency and Critical Care Medicine, Nara Medical University, Kashihara, Nara, Japan. 6. Bureau of EMS & Trauma System, Arizona Department of Health Services, Phoenix, AZ, United States. 7. University of Arizona College of Medicine - Phoenix, Phoenix, AZ, United States. 8. Bureau of EMS & Trauma System, Arizona Department of Health Services, Phoenix, AZ, United States; Arizona Emergency Medicine Research Center, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, United States.
Abstract
AIM OF STUDY: This study aims to quantify the relative impact of Dispatcher-Initiated Telephone cardiopulmonary resuscitation (TCPR) on survival and survival with favorable functional outcome after out-of-hospital cardiac arrest (OHCA) in a population of patients served by multiple emergency dispatch centers and more than 130 emergency medical services (EMS) agencies. METHODS: We conducted a retrospective, observational study of EMS-treated adult (≥18 years) patients with OHCA of presumed cardiac origin in Arizona, between January 1, 2011, and December 31, 2014. We compared survival and functional outcome among three distinct groups of OHCA patients: those who received no CPR before EMS arrival (no CPR group); those who received BCPR before EMS arrival and prior to or without telephone CPR instructions (BCPR group); and those who received TCPR (TCPR group). RESULTS: In this study, 2310 of 4391 patients met the study criteria (median age, 62 years; IQR 50, 74; 1540 male). 32.8% received no CPR, 23.8% received Bystander-Initiated CPR and 43.4% received TCPR. Overall survival was 11.5%. Using no CPR as the reference group, the multivariate adjusted odds ratio for survival at hospital discharge was 1.51 (95% confidence interval [CI], 1.04, 2.18) for BCPR and 1.64 (95% CI, 1.16, 2.30) for TCPR. The multivariate adjusted odds ratio of favorable functional outcome at discharge was 1.58 (95% CI 1.05, 2.39) for BCPR and 1.56 (95% CI, 1.06, 2.31) for TCPR. CONCLUSION: TCPR is independently associated with improved survival and improved functional outcome after OHCA.
AIM OF STUDY: This study aims to quantify the relative impact of Dispatcher-Initiated Telephone cardiopulmonary resuscitation (TCPR) on survival and survival with favorable functional outcome after out-of-hospital cardiac arrest (OHCA) in a population of patients served by multiple emergency dispatch centers and more than 130 emergency medical services (EMS) agencies. METHODS: We conducted a retrospective, observational study of EMS-treated adult (≥18 years) patients with OHCA of presumed cardiac origin in Arizona, between January 1, 2011, and December 31, 2014. We compared survival and functional outcome among three distinct groups of OHCA patients: those who received no CPR before EMS arrival (no CPR group); those who received BCPR before EMS arrival and prior to or without telephone CPR instructions (BCPR group); and those who received TCPR (TCPR group). RESULTS: In this study, 2310 of 4391 patients met the study criteria (median age, 62 years; IQR 50, 74; 1540 male). 32.8% received no CPR, 23.8% received Bystander-Initiated CPR and 43.4% received TCPR. Overall survival was 11.5%. Using no CPR as the reference group, the multivariate adjusted odds ratio for survival at hospital discharge was 1.51 (95% confidence interval [CI], 1.04, 2.18) for BCPR and 1.64 (95% CI, 1.16, 2.30) for TCPR. The multivariate adjusted odds ratio of favorable functional outcome at discharge was 1.58 (95% CI 1.05, 2.39) for BCPR and 1.56 (95% CI, 1.06, 2.31) for TCPR. CONCLUSION:TCPR is independently associated with improved survival and improved functional outcome after OHCA.
Authors: Jerry P Nolan; Robert A Berg; Clifton W Callaway; Laurie J Morrison; Vinay Nadkarni; Gavin D Perkins; Claudio Sandroni; Markus B Skrifvars; Jasmeet Soar; Kjetil Sunde; Alain Cariou Journal: Intensive Care Med Date: 2018-06-02 Impact factor: 17.440
Authors: Audrey L Blewer; Robert H Schmicker; Laurie J Morrison; Tom P Aufderheide; Mohamud Daya; Monique A Starks; Susanne May; Ahamed H Idris; Clifton W Callaway; Peter J Kudenchuk; Gary M Vilke; Benjamin S Abella Journal: Circulation Date: 2019-12-30 Impact factor: 29.690