Bystander CPR and outcomes

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Joined: 24 Mar 2013 01:28
Full Name: Govind Mohan
Name of Your College/Medical School: Madras Medical College

Bystander CPR and outcomes

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Published in Respiratory Medicine
Journal Scan / Research · March 29, 2023

Effect of Training in Basic Life Support and Bystander-Performed CPR on Survival Outcomes of Out-of-Hospital Cardiac Arrest
JAMA Network Open
The authors of this retrospective cohort study aimed to evaluate the association between mandated population-level training in basic life support (BLS) and out-of-hospital cardiac arrest (OHCA) survival outcomes in Denmark. They found a significant association between 30-day survival in patients with OHCA and increased participation in BLS training. Bystander initiation of CPR accounted for 39% of this increase.

The results of this study suggest that population-wide training in BLS has the potential to significantly increase survival in patients with OHCA.

Strategies to improve survival from out-of-hospital cardiac arrest (OHCA) include mass education of laypersons with no official duty to respond to OHCA. In Denmark, basic life support (BLS) course attendance has been mandated by law in October 2006 for obtaining a driver's license for all vehicles and in vocational education programs.

To examine the association between yearly BLS course participation rate and bystander cardiopulmonary resuscitation (CPR) and 30-day survival from OHCA and to examine if bystander CPR rate acted as a mediator on the association between mass education of laypersons in BLS and survival from OHCA.

This cohort study included outcomes for all OHCA incidents from the Danish Cardiac Arrest Register between 2005 and 2019. Data concerning BLS course participation were supplied by the major Danish BLS course providers.

The main outcome was 30-day survival of patients who experienced OHCA. Logistic regression analysis was used to examine the association between BLS training rate, bystander CPR rate, and survival, and a bayesian mediation analysis was conducted to examine mediation.

A total of 51 057 OHCA incidents and 2 717 933 course certificates were included. The study showed that the annual 30-day survival from OHCA increased by 14% (odds ratio [OR], 1.14; 95% CI, 1.10-1.18; P < .001) when BLS course participation rate increased by 5% in analysis adjusted for initial rhythm, automatic external defibrillator use, and mean age. An average mediated proportion of 0.39 (95% QBCI, 0.049-0.818; P = .01). In other words, the last result indicated that 39% of the association between mass educating laypersons in BLS and survival was mediated through an increased bystander CPR rate.

In this cohort study of Danish BLS course participation and survival, a positive association was found between annual rate of mass education in BLS and 30-day survival from OHCA. The association of BLS course participation rate on 30-day survival was mediated by the bystander CPR rate; approximately 60% of the association of BLS course participation rate on 30-day survival was based on factors other than increased CPR rates.

G Mohan
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