Effects of dispatcher-initiated telephone cardiopulmonary resuscitation after out-of-hospital cardiac arrest: A nationwide, population-based, cohort study.

Abstract:

AIM:This study aimed to investigate the effects of dispatcher-initiated telephone cardiopulmonary resuscitation (TCPR) in Japan using a nationwide population-based registry. METHODS:Adult Japanese patients with out-of-hospital cardiac arrest (OHCA; n = 582,483, age ≥18 years) were selected from a nationwide Utstein-style database (2010-2016) and divided into 3 groups: no bystander CPR (NCPR) before emergency medical service arrival (n = 448,606), bystander-initiated CPR (BCPR) performed without assistance (n = 46,964), and TCPR (n = 86,913). The primary outcome was a favourable neurological outcome 1 month after OHCA. RESULTS:After adjusting for potential confounders, and relative to the NCPR group, significantly better 1-month neurological outcomes were observed in the BCPR group (odds ratio: 2.25, 95% confidence interval: 2.15-2.36; P < 0.001) and in the TCPR group (odds ratio: 1.30, 95% confidence interval: 1.24-1.36; P < 0.001). The collapse-to-CPR time was independently associated with the 1-month outcomes, with a rate of <1% for 1-month favourable neurological outcomes if CPR was initiated >5 min after the collapse. CONCLUSION:Patients who received TCPR had significantly better outcomes than those who did not receive CPR. However, the TCPR outcomes were less favourable than those in the BCPR group. Better protocol development and enhanced education are needed to improve dispatcher instructions in Japan, which may help lessen the gap between the BCPR and TCPR outcomes and further improve the outcomes after OHCA.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Shibahashi K,Ishida T,Kuwahara Y,Sugiyama K,Hamabe Y

doi

10.1016/j.resuscitation.2019.08.031

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

6-14

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(19)30592-1

journal_volume

144

pub_type

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