Jan Wnent1, Ingvild Tjelmeland2, Rolf Lefering3, Rudolph W Koster4, Holger Maurer5, Siobhán Masterson6, Johan Herlitz7, Bernd W Böttiger8, Fernando Rosell Ortiz9, Gavin D Perkins10, Leo Bossaert11, Maximilian Moertl12, Pierre Mols13, Irzal Hadžibegović14, Anatolij Truhlář15, Ari Salo16, Valentine Baert17, Eniko Nagy18, Grzegorz Cebula19, Violetta Raffay20, Stefan Trenkler21, Andrej Markota22, Anneli Strömsöe23, Jan-Thorsten Gräsner24. 1. University Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany; University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Kiel, Germany; University of Namibia, School of Medicine, Windhoek, Namibia. Electronic address: Jan.wnent@uksh.de. 2. University Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany; Division of Prehospital Services, Oslo University Hospital, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Norway. 3. Institute for Research in Operative Medicine (IFOM), Faculty of Health, University Witten/Herdecke, Cologne, Germany. 4. Department of Cardiology, Amsterdam UMC, Location Academic Medical Center, Amsterdam, The Netherlands. 5. University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Lübeck, Germany. 6. National Ambulance Service and National University of Ireland Galway (on behalf of the Out-of-Hospital Cardiac Arrest Register (OHCAR)), Ireland. 7. Prehospen-Centre for Prehospital Research, Faculty of Caring Science, Work-Life and Social Welfare, University of Borås, Borås, Sweden. 8. Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany; European Resuscitation Council, Niel, Belgium. 9. Servicio de Urgencias y Emergencias 061 de La Rioja, Spain. 10. Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom; University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; European Resuscitation Council, Niel, Belgium. 11. University of Antwerp, Antwerp, Belgium; European Resuscitation Council, Niel, Belgium. 12. Medical University of Innsbruck, Department of Anaesthesia and Intensive Care, Innsbruck, Austria. 13. Service des Urgences et du SMUR, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Belgium. 14. University Hospital Dubrava Zagreb, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University Osijek, Croatia. 15. Emergency Medical Services of the Hradec Králové Region, Hradec Králové, Czech Republic; Department of Anaesthesiology and Intensive Care Medicine, Charles University Prague, Faculty of Medicine Hradec Králové, University Hospital Hradec Králové, Czech Republic. 16. Department of Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 17. Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000 Lille, France. 18. Hungarian Resuscitation Council. 19. Jagiellonian University Medical College, Department of Medical Education, Poland. 20. Serbian Resuscitation Council, Novi Sad, Serbia; European University Cyprus, School of Medicine, Nicosia, Cyprus. 21. P. J. Safarik University, Medical Faculty, L. Pasteur University Hospital, Department of Anaesthesiology and Intensive Medicine, Kosice, Slovakia. 22. Medical Intensive Care Unit, University Medical Centre Maribor, Maribor, Slovenia; Slovenian Resuscitation Council, Slovenian Society for Emergency Medicine, Ljubljana, Slovenia. 23. School of Education, Health and Social Studies, Dalarna University S-79188 Falun, Sweden; Centre for Clinical Research Dalarna, Uppsala University S-79182 Falun, Sweden; Department of Prehospital Care, Region of Dalarna, S-79129 Falun, Sweden. 24. University Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany; University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Kiel, Germany; European Resuscitation Council, Niel, Belgium.
Abstract
BACKGROUND: Survival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR). METHOD: In this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed. RESULTS: A total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17-1.83). CONCLUSION: In this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both.
BACKGROUND: Survival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR). METHOD: In this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed. RESULTS: A total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17-1.83). CONCLUSION: In this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both.