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Bystander CPR associated with out-of-hospital cardiac arrest survival
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From 2001 to 2010, an increase in survival rates following out-of-hospital cardiac arrest was associated with a concurrent increase in bystander cardiopulmonary resuscitation in Denmark.
Researchers examined data from the Danish Cardiac Arrest Registry from June 2001 to December 2010 to assess the effectiveness of initiatives to increase rates of bystander CPR in Denmark.
The analysis included 19,468 patients (median age, 72 years; 67% men) who had an out-of-hospital cardiac arrest from 2001 to 2010.
During the study period, bystander CPR increased from 21.1% in 2001 to 44.9% in 2010, despite low use of defibrillation by bystanders (2001, 1.1%; 2010, 2.2%).
Survival on hospital arrival also improved (7.9% to 21.8%), as did 30-day survival (3.5% to 10.8%) and 1-year survival (2.9% to 10.2%).
The incidence of out-of-hospital cardiac arrest decreased (40.4 per 100,000 people to 34.4 per 100,000 people; P=.002) and the researchers noted an increase in the number of survivors on hospital arrival, survivors at 30 days and survivors at 1 year (P<.001).
Bystander CPR was positively associated with 30-day survival. For nonwitnessed cardiac arrest, the 30-day survival rate was 4.3% with bystander CPR and 1% with no bystander CPR (OR=4.38; 95% CI, 3.17-6.06). For witnessed cardiac arrest, the 30-day survival rate was 19.4% with bystander CPR and 6.1% with no bystander CPR (OR=3.74; 95% CI, 3.26-4.28).
Although the researchers found a significant link between increased bystander CPR and increased survival rates for out-of-hospital cardiac arrest, they said they could not draw any conclusions about a causal relationship because of other related initiatives that occurred during the study period.
“The reason for improved survival is probably multifactoral and most likely related to improvements in each of the links in the chain of survival, as well as other factors that influence survival,” Mads Wissenberg, MD, from the department of cardiology at Copenhagen University Hospital Gentofte, and colleagues wrote. “This notion is supported by the observation that 30-day survival increased among patients both with and without bystander CPR.”
Disclosure: Various researchers report financial ties to AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Cardiome, Daiichi, Merck, Sanofi and Servier.
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