Lucile Noel1, Deborah Jaeger2, Valentine Baert3, Guillaume Debaty4, Michael Genin3, Sonia Sadoune1, Adrien Bassand1, Karim Tazarourte5, Pierre-Yves Gueugniaud6, Carlos El Khoury7, Hervé Hubert3, Tahar Chouihed8. 1. Emergency Department, University Hospital of Nancy, France. 2. Emergency Department, University Hospital of Nancy, France; INSERM, Clinical Investigation Center - Unit 1433, University Hospital of Nancy, Vandoeuvre les, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France. 3. Univ. Lille, CHU Lille, EA2694 - Santé Publique: Épidémiologie et Qualité des Soins, F-59000 Lille, France; French National Out-of-Hospital Cardiac Arrest Registry, RéAC, Lille, France. 4. University Grenoble Alps/CNRS/CHU de Grenoble Alpes/TIMC-IMAG UMR 5525, Grenoble, France. 5. Emergency "URMARS" Pole, Edouard Herriot Hospital Group, HCL, Lyon, France; Health Services and Performance Research, HESPER, EA7425, Claude Bernard University, Lyon 1, France. 6. French National Out-of-Hospital Cardiac Arrest Registry, RéAC, Lille, France; Emergency "URMARS" Pole, Edouard Herriot Hospital Group, HCL, Lyon, France. 7. Health Services and Performance Research, HESPER, EA7425, Claude Bernard University, Lyon 1, France; Emergency Department and RESCUe Network, Lucien Hussel Hospital, France. 8. Emergency Department, University Hospital of Nancy, France; INSERM, Clinical Investigation Center - Unit 1433, University Hospital of Nancy, Vandoeuvre les, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France; F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France. Electronic address: t.chouihed@chru-nancy.fr.
Abstract
AIM: Cardiac arrest (CA) was considered irreversible until 1960, when basic cardiopulmonary resuscitation (CPR) was defined. CPR guidelines include early recognition of CA, rapid and effective CPR, effective defibrillation strategies and organized post-resuscitation to ensure a strengthening of the survival chain. Bystanders are the key to extremely early management, which is associated with the early medical care provided by EMS. This study aims to assess the prognosis of a bystander's cardiac CPR when it is initiated by the Dispatch Centre (DC). METHODS: We included patients in 3 groups according to who initiated the CPR. The groups were matched according to multiple propensity partition methods. We presented our results in terms of 30-day survival and neurological prognosis. RESULTS: 85,634 patients were included. Statistical study focused on 18,185 patients once the exclusion criteria were applied. 12,743 (70.1%) are men and the average age is 70.1 years. Survival at D30 was 5.11% in the absence of CPR, 8.86% with bystander initiation and 7.35% with DC initiation (p < 0.001). Survival at D30 with favourable neurologic prognosis (CPC 1-2) was 76.30%, 83.69% and 82.82%, respectively. Our results show a 3.75% increase in the chance of survival at D30 if CPR was initiated by bystanders compared to patients for whom CPR was not initiated, a 2.25% increase in survival in the group that received from CPR initiated by the DC compared to the group that did not receive CPR. CONCLUSIONS: Bystander CPR initiated by the DC represents a suitable option following out-of-hospital cardiac arrest.
AIM: Cardiac arrest (CA) was considered irreversible until 1960, when basic cardiopulmonary resuscitation (CPR) was defined. CPR guidelines include early recognition of CA, rapid and effective CPR, effective defibrillation strategies and organized post-resuscitation to ensure a strengthening of the survival chain. Bystanders are the key to extremely early management, which is associated with the early medical care provided by EMS. This study aims to assess the prognosis of a bystander's cardiac CPR when it is initiated by the Dispatch Centre (DC). METHODS: We included patients in 3 groups according to who initiated the CPR. The groups were matched according to multiple propensity partition methods. We presented our results in terms of 30-day survival and neurological prognosis. RESULTS: 85,634 patients were included. Statistical study focused on 18,185 patients once the exclusion criteria were applied. 12,743 (70.1%) are men and the average age is 70.1 years. Survival at D30 was 5.11% in the absence of CPR, 8.86% with bystander initiation and 7.35% with DC initiation (p < 0.001). Survival at D30 with favourable neurologic prognosis (CPC 1-2) was 76.30%, 83.69% and 82.82%, respectively. Our results show a 3.75% increase in the chance of survival at D30 if CPR was initiated by bystanders compared to patients for whom CPR was not initiated, a 2.25% increase in survival in the group that received from CPR initiated by the DC compared to the group that did not receive CPR. CONCLUSIONS: Bystander CPR initiated by the DC represents a suitable option following out-of-hospital cardiac arrest.
Authors: Richard Chocron; Julia Jobe; Sally Guan; Madeleine Kim; Mia Shigemura; Carol Fahrenbruch; Thomas Rea Journal: J Am Heart Assoc Date: 2021-03-04 Impact factor: 5.501
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