Time factors rather than type and/or nature of CPR modify the prognosis of out-of-hospital cardiac arrests witnessed by bystanders

Introduction

The purpose of the study was to analyze the effects of the type and nature of CPR on the prognosis of out-of-hospital cardiac arrests (OHCAs).

Methods

We analyzed 1,612 OHCAs, witnessed by citizens and handled by the dispatch system in Ishikawa, Japan, from 1 April 2003 to 31 March 2008. Bystander CPR was classified into four groups according to type (CC only or CC + MMV) and nature (under one's own initiative or telephone-assisted instruction).

Results

The presence of bystander CPR significantly augmented the 1-month survival rate. However, there were no significant differences among the four groups of CPR. The multivariate logistic regression analysis identified three time factors including intervals of collapse-to-call, call-to-first CPR, call-to-arrival to patients as independent factors associated with 1-month survival. See Figures 1 and 2.

Figure 1

Effect of bystander CPR on the 1-month survival rate.

Figure 2

Factors associated with 1-month survival

Conclusions

Significance of correctable time factors rather than type of CPR should be considered in the future guideline revision.