Hiroyuki Takahashi1, Ryo Sagisaka2, Yoshiki Natsume3, Shota Tanaka4, Hiroshi Takyu5, Hideharu Tanaka6. 1. Department of Sports Medicine, Kokushikan University, Japan; Research Institute of Disaster Management and EMS, Kokushikan University, Japan. 2. Department of EMS Systems, Graduate School, Kokushikan University, Japan. 3. Kyoto Tachibana University, Japan. 4. Research Institute of Disaster Management and EMS, Kokushikan University, Japan. 5. Department of Sports Medicine, Kokushikan University, Japan; Department of EMS Systems, Graduate School, Kokushikan University, Japan. 6. Department of Sports Medicine, Kokushikan University, Japan; Department of EMS Systems, Graduate School, Kokushikan University, Japan; Research Institute of Disaster Management and EMS, Kokushikan University, Japan. Electronic address: hidetana@kokushika.ac.jp.
Abstract
AIM: We investigated whether DA-CPR would have the same effect as spontaneously-delivered bystander CPR. METHODS: A total of 37,899 witnessed cardiogenic out of hospital cardiac arrest (OHCA) selected from a nationwide Utstein-Japanese database between 2008 and 2012. Patients were divided into four groups as follows: CPR initiated with dispatcher assistance (DA-CPR; n=10,424), no CPR provided with dispatcher assistance (DA-No CPR; n=4658), spontaneously-delivered bystander CPR provided without DA (BCPR; n=6630), and both BCPR and dispatcher assistance was not provided (No BCPR-No DA; n=16,187). The primary endpoint was rate of shockable rhythm on the initial ECG, return of spontaneous circulation (ROSC) on the field. A multivariable logistic regression analysis was used. Adjusted odds ratios (AOR) are presented as 95% confidence intervals (95% CIs) among the groups. RESULTS: The rate of DA-CPR implementation has gradually increased since 2005. In comparison with DA-No CPR, both spontaneously-delivered BCPR and DA-CPR were significantly associated with the following factors: increased rate of shockable rhythm on the initial ECG (AOR, 1.75 and 1.72; 95% CI, 1.67 to 1.85 and 1.63 to 1.83),improved field ROSC (AOR, 1.42 and 1.40; 95% CI, 1.33 to 1.52 and 1.30 to 1.51) and 1-month favorable neurological outcomes (AOR, 1.72 and 1.80; 95% CI, 1.59 to 1.88 and 1.64 to 1.97), respectively. CONCLUSIONS: We found that the spontaneously delivered BCPR group showed favorable results. In comparison to the DA-No BCPR group, DA-CPR group resulted in the nearly equivalent effect as spontaneously-delivered BCPR group. Further standard dispatcher education is indicated.
AIM: We investigated whether DA-CPR would have the same effect as spontaneously-delivered bystander CPR. METHODS: A total of 37,899 witnessed cardiogenic out of hospital cardiac arrest (OHCA) selected from a nationwide Utstein-Japanese database between 2008 and 2012. Patients were divided into four groups as follows: CPR initiated with dispatcher assistance (DA-CPR; n=10,424), no CPR provided with dispatcher assistance (DA-No CPR; n=4658), spontaneously-delivered bystander CPR provided without DA (BCPR; n=6630), and both BCPR and dispatcher assistance was not provided (No BCPR-No DA; n=16,187). The primary endpoint was rate of shockable rhythm on the initial ECG, return of spontaneous circulation (ROSC) on the field. A multivariable logistic regression analysis was used. Adjusted odds ratios (AOR) are presented as 95% confidence intervals (95% CIs) among the groups. RESULTS: The rate of DA-CPR implementation has gradually increased since 2005. In comparison with DA-No CPR, both spontaneously-delivered BCPR and DA-CPR were significantly associated with the following factors: increased rate of shockable rhythm on the initial ECG (AOR, 1.75 and 1.72; 95% CI, 1.67 to 1.85 and 1.63 to 1.83),improved field ROSC (AOR, 1.42 and 1.40; 95% CI, 1.33 to 1.52 and 1.30 to 1.51) and 1-month favorable neurological outcomes (AOR, 1.72 and 1.80; 95% CI, 1.59 to 1.88 and 1.64 to 1.97), respectively. CONCLUSIONS: We found that the spontaneously delivered BCPR group showed favorable results. In comparison to the DA-No BCPR group, DA-CPR group resulted in the nearly equivalent effect as spontaneously-delivered BCPR group. Further standard dispatcher education is indicated.
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