The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis

Yan, Shijiao; Gan, Yong; Jiang, Nan; Wang, Rixing; Chen, Yunqiang; Luo, Zhiqian; Zong, Qiao; Chen, Song; Lv, Chuanzhu

doi:10.1186/s13054-020-2773-2

Critical Care

Table 1 The incidence of ROSC, survival to admission, survival to discharge, 1 month survival, and 1 year survival: the overall estimates and subgroup analyses

From: The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis

	No. of reports	Survivors	OHCA cases	Proportion (%)	95%CI	I²	P value for heterogeneity
ROSC*	74	203,084	1,560,830	29.7	27.6 to 31.7	99.90%	< 0.001
Sex
Men	2	242	856	28.9	24.2 to 33.6	43.4%	0.184
Women	2	151	478	31.6	27.4 to 35.8	0.00%	0.542
Combined	70	202,691	1,559,496	29.7	27.6 to 31.8	99.90%	< 0.001
Study location
Europe	32	4166	12,274	36.7	32.4 to 40.9	96.10%	< 0.001
Asia	17	186,060	1,500,110	22.1	18.1 to 26.0	100.00%	< 0.001
North America	20	6981	32,520	24.3	19.7 to 28.9	99.10%	< 0.001
Oceania	5	5877	15,926	38.6	22.9 to 54.2	99.20%	< 0.001
Study period
1976–1999	25	3706	15,429	34.2	28.0 to 40.4	98.70%	< 0.001
2000–2009	30	4091	17,159	28.3	23.9 to 32.7	98.00%	< 0.001
2010–2019	19	195,287	1,528,242	27.5	23.6 to 31.3	100.00%	< 0.001
CPR type
Bystander CPR	17	138,149	863,978	26.3	20.9 to 31.8	100.00%	< 0.001
EMS CPR	15	45,505	624,496	36.3	23.8 to 48.9	99.50%	< 0.001
Unspecific CPR	42	19,430	72,356	29.6	25.9 to 33.3	99.30%	< 0.001
Origin of OHCA
Cardiac etiology	49	30,531	143,831	33.9	30.1 to 37.7	99.50%	< 0.001
Non-traumatic	14	7652	33,318	21.5	16.2 to 26.8	99.20%	< 0.001
All patients	11	164,901	1,383,681	23.3	18.3 to 28.3	100.00%	< 0.001
Others	NA	NA	NA	NA	NA	NA	NA
Witnessed type
Witnessed	31	106,894	440,281	36.4	30.6 to 42.2	99.90%	< 0.001
Not witnessed	1	34	93	36.6	26.8 to 46.4	0.00%	< 0.001
Mixed	36	95,828	1,119,248	23.7	22.2 to 25.3	99.80%	< 0.001
Unspecific events	6	328	1208	28.2	18.6 to 37.7	91.30%	< 0.001
Survival to admission†	122	55,026	377,727	22.0	20.7 to 23.4	99.4%	< 0.001
Sex
Men	7	564	2829	20.3	16.3 to 24.3	81.00%	< 0.001
Women	7	254	1021	23.4	17.8 to 29.1	72.60%	< 0.001
Combined	108	54,208	373,877	22.1	20.6 to 23.5	99.40%	< 0.001
Study location
Europe	52	20,987	123,024	25.7	23.9 to 27.6	98.30%	< 0.001
Asia	27	23,551	203,283	15.6	13.2 to 18.0	99.70%	< 0.001
North America	39	5504	35,183	20.5	18.1 to 22.9	97.50%	< 0.001
Oceania	4	4984	16,237	33.5	21.7 to 45.3	98.90%	< 0.001
Study period
1976–1999	59	5704	33,083	22.4	20.0 to 24.8	97.30%	< 0.001
2000–2009	38	18,433	106,336	25.1	22.9 to 27.3	98.50%	< 0.001
2010–2019	25	30,889	238,308	17.2	14.4 to 19.9	99.80%	< 0.001
CPR type
Bystander CPR	21	6660	44,028	22.8	18.8 to 26.8	99.10%	< 0.001
EMS CPR	23	2043	7657	25.5	19.7 to 31.2	97.40%	< 0.001
Unspecific CPR	78	46,323	326,042	21.1	19.5 to 22.7	99.50%	< 0.001
Origin of OHCA
Cardiac etiology	66	22,682	143,612	23.5	21.2 to 25.9	99.50%	< 0.001
Non-traumatic	38	17,293	142,532	19.3	17.5 to 21.2	98.60%	< 0.001
All patients	11	13,953	86,443	20.4	17.1 to 23.7	99.10%	< 0.001
Others	7	1098	5140	23.6	19.4 to 27.7	91.50%	< 0.001
Witnessed type
Witnessed	37	12,027	88,992	23.2	20.3 to 26.1	99.60%	< 0.001
Not witnessed	1	23	93	24.7	15.9 to 33.5	0.00%	< 0.001
Mixed	75	42,630	286,470	21.6	20.1 to 23.1	99.10%	< 0.001
Unspecific events	9	346	2172	19.2	14.5 to 23.9	84.30%	< 0.001
Survival to discharge^‡	168	20,946	267,862	8.8	8.2 to 9.4	97.60%	< 0.001
Sex
Men	22	1576	26,666	7.4	6.2 to 8.7	93.60%	< 0.001
Women	21	723	13,570	7.2	5.6 to 8.7	91.70%	< 0.001
Combined	125	18,647	227,626	9.3	8.5 to 10.0	97.90%	< 0.001
Study location
Europe	59	3607	33,673	11.7	10.5 to 13.0	92.70%	< 0.001
Asia	16	5329	86,333	4.5	3.1 to 5.9	98.60%	< 0.001
North America	89	10,115	131,564	7.7	6.9 to 8.6	97.60%	< 0.001
Oceania	4	1895	16,292	16.2	5.9 to 26.5	99.10%	< 0.001
Study period
1976–1999	80	4851	59,816	8.6	7.7 to 9.5	95.00%	< 0.001
2000–2009	63	5612	78,018	8.6	7.5 to 9.6	97.20%	< 0.001
2010–2019	25	10,483	130,028	9.9	8.4 to 11.4	99.10%	< 0.001
CPR type
Bystander CPR	35	4493	39,974	11.3	9.3 to 13.2	97.40%	< 0.001
EMS CPR	27	1754	14,108	10.7	8.2 to 13.2	95.80%	< 0.001
Unspecific CPR	106	14,699	213,780	7.7	7.0 to 8.3	97.40%	< 0.001
Origin of OHCA
Cardiac etiology	84	11,765	132,292	10.0	9.1 to 10.9	97.00%	< 0.001
Non-traumatic	62	7117	111,171	7.0	6.2 to 7.9	97.70%	< 0.001
All patients	13	879	9826	8.3	5.4 to 11.2	96.00%	< 0.001
Others	9	1185	14,573	10.1	8.3 to 12.0	89.50%	< 0.001
Witnessed type
Witnessed	44	8967	97,069	10.5	9.2 to 11.7	97.60%	< 0.001
Not witnessed	3	16	324	4.4	1.4 to 7.4	40.00%	0.189
Mixed	118	11,951	170,341	8.2	7.5 to 8.9	97.20%	< 0.001
Unspecific events	3	12	128	8.9	4.0 to 13.8	0.00%	0.705
One-month survival^§	54	247,999	2,362,223	10.7	9.1 to 12.3	99.9%	< 0.001
Sex
Men	4	3968	46,831	8.0	5.2 to 10.9	99.10%	< 0.001
Women	4	2477	18,891	9.5	3.2 to 15.8	99.50%	< 0.001
Combined	45	241,554	2,296,501	11.0	9.3 to 12.8	100%	< 0.001
Study location
Europe	28	25,371	292,473	9.0	7.6 to 10.3	99.50%	< 0.001
Asia	21	222,285	2,066,705	12.8	10.0 to 15.5	100%	< 0.001
North America	2	41	623	6.5	4.6 to 8.5	0.00%	0.415
Oceania	3	302	2422	16.0	8.4 to 23.7	96.10%	< 0.001
Study period
1976–1999	NA	NA	NA	NA	NA	NA	NA
2000–2009	28	17,304	219,965	8.0	6.7 to 9.3	99.3%	< 0.001
2010–2019	26	230,695	2,142,258	13.3	10.9 to 15.7	100%	< 0.001
CPR type
Bystander CPR	25	161,386	1,074,767	12.8	9.0 to 16.7	100%	< 0.001
EMS CPR	6	37,308	666,669	12.3	8.6 to 16.0	99.70%	< 0.001
Unspecific CPR	23	49,305	620,787	7.9	7.1 to 8.7	99.20%	< 0.001
Origin of OHCA
Cardiac etiology	26	21,262	208,631	10.5	9.1 to 12.0	99.10%	< 0.001
Non-traumatic	1	23	342	6.7	4.1 to 9.3	0	< 0.001
All patients	27	226,714	2,153,250	10.8	8.5 to 13.1	100%	< 0.001
Others	NA	NA	NA	NA	NA	NA	NA
Witnessed type
Witnessed	27	169,542	1,055,935	13.2	10.3 to 16.1	99.9%	< 0.001
Not witnessed	NA	NA	NA	NA	NA	NA	NA
Mixed	27	78,457	1,306,288	8.3	7.4 to 9.1	99.7%	< 0.001
Unspecific events	NA	NA	NA	NA	NA	NA	NA
One-year survival¶	27	3791	42,027	7.7	5.8 to 9.5	97.5%	< 0.001
Sex
Men	1	13	320	4.1	1.9 to 6.3	0.00%	< 0.001
Women	1	14	219	6.4	3.2 to 9.6	0.00%	< 0.001
Combined	25	3764	41,488	7.9	5.9 to 9.8	97.7%	< 0.001
Study location
Europe	16	3378	35,604	9.2	6.4 to 12.0	98.2%	< 0.001
Asia	3	118	2504	5.3	2.7 to 8.0	87.8%	< 0.001
North America	7	96	2190	4.0	2.8 to 5.3	51.2%	0.056
Oceania	1	199	1729	11.5	10.0 to 13.0	0.0%	< 0.001
Study period
1976–1999	10	407	3517	8.5	4.1 to 12.8	96.6%	< 0.001
2000–2009	14	479	7496	6.0	4.3 to 7.6	89.0%	< 0.001
2010–2019	3	2905	31,014	12.3	5.4 to 19.3	99.6%	< 0.001
CPR type
Bystander CPR	2	1579	10,805	12.3	6.4 to 18.1	79.6%	0.027
EMS CPR	3	17	480	3.2	0.5 to 6.0	64.6%	0.059
Unspecific CPR	22	2195	30,742	7.6	6.1 to 9.2	95.2%	< 0.001
Origin of OHCA
Cardiac etiology	25	3763	41,493	7.9	6.0 to 9.9	97.6%	< 0.001
Non-traumatic	1	24	338	7.1	4.4 to 9.8	0.0%	< 0.001
All patients	NA	NA	NA	NA	NA	NA	NA
Others	1	4	196	2.0	0 to 4.0	0.0%	< 0.001
Witnessed type
Witnessed	12	283	5765	5.3	4.0 to 6.5	77.9%	< 0.001
Not witnessed	NA	NA	NA	NA	NA	NA	NA
Mixed	15	3508	36,262	9.0	6.1 to 11.9	98.3%	< 0.001
Unspecific events	NA	NA	NA	NA	NA	NA	NA

Note: CI confidence interval, CPR cardiopulmonary resuscitation, EMS emergency medical services, NA not available, OHCA out-of-hospital cardiac arrests, ROSC return of spontaneous circulation
*Two studies reported their results by study location, 2 studies reported their results by sex, 4 studies reported their results by CPR type, 2 studies reported their results by witness type, and 1 study reported their results by OHCA type; therefore, there were 74 reports from 62 studies
†Four studies reported their results by study location, 7 studies reported their results by sex, 7 studies reported their results by CPR type, 2 studies reported their results by witness type, and 1 study reported their results by OHCA type; therefore, there were 122 reports from 88 studies
^‡Three studies reported their results by study location, 21 studies reported their results by sex, 16 studies reported their results by CPR type, 1 study reported their results by witness type, and 2 studies reported their results by OHCA type; therefore, there were 168 reports from 103 studies
^§Four studies reported their results by sex, 4 studies reported their results by CPR type, 2 studies reported their results by OHCA type, and 1 study reported their results by year; therefore, there were 54 reports from 33 studies
¶One study reported their results by sex, 2 studies reported their results by CPR type, and 1 study reported their results by witness type; therefore, there were 27 reports from 22 studies

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