Copyright © 2001 by the European Society of Cardiology.
Factors modifying the effect of bystander cardiopulmonary resuscitation on survival in out-of-hospital cardiac arrest patients in Sweden
Department of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden
Received June 4, 2000; accepted August 9, 2000
Abstract
Aim To describe possible factors modifying the effect of bystander cardiopulmonary resuscitation on survival among patients suffering an out-of-hospital cardiac arrest.
Patients A national survey in Sweden among patients suffering out-of-hospital cardiac arrest and in whom resuscitative efforts were attempted. Sixty per cent of ambulance organizations were included.
Design Prospective evaluation. Survival was defined as survival 1 month after cardiac arrest.
Results In all, 14065 reports were included in the evaluation. Of these, resuscitation efforts were attempted in 10966 cases, of which 1089 were witnessed by ambulance crews. The report deals with the remaining 9877 patients, of whom bystander cardiopulmonary resuscitation was attempted in 36%. Survival to 1 month was 8·2% among patients who received bystander cardiopulmonary resuscitation vs 2·5% among patients who did not receive it (odds ratio 3·5, 95% confidence interval 2·9–4·3). The effect of bystander cardiopulmonary resuscitation on survival was related to: (1) the interval between collapse and the start of bystander cardiopulmonary resuscitation (effect more marked in patients who experienced a short delay); (2) the quality of bystander cardiopulmonary resuscitation (effect more marked if both chest compressions and ventilation were performed than if either of them was performed alone); (3) the category of bystander (effect more marked if bystander cardiopulmonary resuscitation was performed by a non-layperson); (4) interval between collapse and arrival of the ambulance (effect more marked if this interval was prolonged); (5) age (effect more marked in bystander cardiopulmonary resuscitation among the elderly); and (6) the location of the arrest (effect more marked if the arrest took place outside the home).
Conclusion The effect of bystander cardiopulmonary resuscitation on survival after an out-of-hospital cardiac arrest can be modified by various factors. Factors that were associated with the effect of bystander cardiopulmonary resuscitation were the interval between the collapse and the start of bystander cardiopulmonary resuscitation, the quality of bystander cardiopulmonary resuscitation, whether or not the bystander was a layperson, the interval between collapse and the arrival of the ambulance, age and the place of arrest.
Key Words: Cardiopulmonary resuscitation, bystander, cardiac arrest
f1 Correspondence: Mikael Holmberg MD, Department of Cardiology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
References
- Cummins RO, Eisenberg MS, Hallstrom AP, Litwin PE. Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. Am J Emerg Med. 1985;3:114–119[CrossRef][Web of Science][Medline]
- Swor RA, Jackson RE, Cynar M. Bystander CPR, ventricular fibrillation, and survival in witnessed, unmonitored out-of-hospital cardiac arrest. Ann Emerg Med. 1995;25:780–784[CrossRef][Web of Science][Medline]
- Stiell IG, Wells GA, DeMaio VJ. Modifiable factors associated with improved cardiac arrest survival in a multicenter basic life support/defibrillation system: OPALS study phase I results. Ann Emerg Med. 1999;33:44–50[CrossRef][Web of Science][Medline]
- Stiell I, Wells G, Spaite D. The Ontario Prehospital Advanced Life Support (OPALS) study Part II: Rationale and methodology for trauma and respiratory distress patients. OPALS Study Group. Ann Emerg Med. 1999;34:256–262[CrossRef][Web of Science][Medline]
- Gallagher EJ, Lombardi G, Gennis P. Effectiveness of bystander cardiopulmonary resuscitation and survival following out-of-hospital cardiac arrest. JAMA. 1995;274:1922–1925
[Abstract/Free Full Text] - Wik L, Steen PA, Bircher NG. Quality of bystander cardiopulmonary resuscitation influences outcome after prehospital cardiac arrest. Resuscitation. 1994;28:195–203[CrossRef][Web of Science][Medline]
- Valenzuela TD, Roe DJ, Cretin S, Spaite DW, Larsen MP. Estimating effectiveness of cardiac arrest interventions: a logistic regression survival model. Circulation. 1997;96:3308–3313
[Abstract/Free Full Text] - Litwin PE, Eisenberg MS, Hallstrom AP, Cummins RO. The location of collapse and its effect on survival from cardiac arrest. Ann Emerg Med. 1987;16:787–791[CrossRef][Web of Science][Medline]
- Anonymous. Guidelines for advanced life support. A statement by the Advanced Life Support Working Party of the European Resuscitation Council, 1992. Resuscitation. 1992;24:111–121[CrossRef][Web of Science][Medline]
- Cummins RO, Ornato JP, Thies WH, Pepe PE. Improving Survival from Sudden Cardiac Arrest: The ‘Chain of Survival’ Concept. Circulation. 1991;83:1832–1847
[Free Full Text] - Jackson RJ, Freeman SB. Hemodynamics of cardiac massage. Emerg Med Clin North Am. 1991;1:501–513
- Duggal C, Weil M, Tang W, Gazmuri R, Sun S. Effect of arrest time on the hemodynamic efficacy of precordial compression. Crit Care Med. 1995;23:1233–1236[CrossRef][Web of Science][Medline]
- Bossaert L, Van Hoeyweghen R. Bystander cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest. The Cerebral Resuscitation Study Group. Resuscitation. 1989;17:S55–69
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  B. Ali and A. M. Zafari Narrative Review: Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: Review of the Current Guidelines Ann Intern Med, August 7, 2007; 147(3): 171 - 179. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Yannopoulos and T. Aufderheide Acute management of sudden cardiac death in adults based upon the new CPR guidelines Europace, January 1, 2007; 9(1): 2 - 9. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 The International Liaison Committee on Resuscitati The International Liaison Committee on Resuscitation (ILCOR) Consensus on Science With Treatment Recommendations for Pediatric and Neonatal Patients: Pediatric Basic and Advanced Life Support Pediatrics, May 1, 2006; 117(5): e955 - e977. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Part 3: Overview of CPR Circulation, December 13, 2005; 112(24_suppl): IV-12 - IV-18. [Full Text] [PDF]
|
|
|
|
|
|
Part 4: Adult Basic Life Support Circulation, December 13, 2005; 112(24_suppl): IV-19 - IV-34. [Full Text] [PDF]
|
|
|
|
|
|
Part 6: Pediatric Basic and Advanced Life Support Circulation, November 29, 2005; 112(22_suppl): III-73 - III-90. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Herlitz, J. Engdahl, L. Svensson, M. Young, K.-A. Angquist, and S. Holmberg A short delay from out of hospital cardiac arrest to call for ambulance increases survival Eur. Heart J., October 1, 2003; 24(19): 1750 - 1755. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. J.J. Wellens, A. P. Gorgels, and H. de Munter Cardiac Arrest Outside of a Hospital: How Can We Improve Results of Resuscitation? Circulation, April 22, 2003; 107(15): 1948 - 1950. [Full Text] [PDF]
|
|
|
|
 |
|
 J Herlitz, M Eek, M Holmberg, J Engdahl, and S Holmberg Characteristics and outcome among patients having out of hospital cardiac arrest at home compared with elsewhere Heart, December 1, 2002; 88(6): 579 - 582. [Abstract] [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||