Cardiopulmonary resuscitation performed by off-duty medical professionals versus laypersons and survival from out-of-hospital cardiac arrest among adult patients

Resuscitation. 2019 Feb:135:66-72. doi: 10.1016/j.resuscitation.2019.01.005. Epub 2019 Jan 9.

Abstract

Background: Cardiopulmonary resuscitation (CPR) performed by bystanders is a key factor for out-of-hospital cardiac arrest (OHCA) survival. This study aimed to evaluate the relationship between CPR performed by off-duty medical professionals vs. laypersons and one-month survival with favorable neurological outcome after OHCA.

Methods: Using a population-based database of OHCA patients in Osaka City, Japan, from 2013 through 2015, we enrolled adult OHCA patients with resuscitation attempts performed by bystanders before the arrival of emergency-medical-service personnel. Multivariable logistic regression analysis was performed to assess the association between CPR performed by off-duty medical professionals vs. laypersons and the OHCA outcome after adjusting for potential confounding factors. The primary outcome measure was one-month survival with favorable neurological outcome, defined as cerebral performance category of 1 or 2.

Results: A total of 2326 subjects were eligible for our study. Among these, 365 (15.7%) patients received CPR by off-duty medical professionals and 1,961 (84.3%) received CPR by laypersons. In the multivariable analysis, there was no difference in favorable neurological outcome between off-duty medical professionals (6.3% [23/365]) and laypersons (5.1% [100/1,961]) among eligible patients (adjusted odds ratio 0.83, 95% confidence interval [0.37-2.06]). This finding was also confirmed in propensity score-matched patients.

Conclusions: In Japan where the CPR training or bystander CPR has been widely disseminating, CPR by laypersons had similar effects compared to that by off-duty medical professionals. As this study could not assess the quality of bystander CPR, further studies are essential to verify the effects of the bystander CPR type on OHCA patients.

Keywords: Bystander; Cardiopulmonary resuscitation; Out-of-hospital cardiac arrest; Outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cardiopulmonary Resuscitation* / methods
  • Cardiopulmonary Resuscitation* / standards
  • Cardiopulmonary Resuscitation* / statistics & numerical data
  • Emergency Medical Services* / methods
  • Emergency Medical Services* / standards
  • Emergency Medical Services* / statistics & numerical data
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Out-of-Hospital Cardiac Arrest* / mortality
  • Out-of-Hospital Cardiac Arrest* / therapy
  • Outcome and Process Assessment, Health Care
  • Registries / statistics & numerical data
  • Survival Analysis