Effect of Dispatcher-Assisted Cardiopulmonary Resuscitation Program and Location of Out-of-Hospital Cardiac Arrest on Survival and Neurologic Outcome

Young Sun Ro, Sang Do Shin, Yu Jin Lee, Seung Chul Lee, Kyoung Jun Song, Hyun Wook Ryoo, Marcus Eng Hock Ong, Bryan McNally, Bentley J Bobrow, Hideharu Tanaka, Helge Myklebust, Tonje Søraas Birkenes

Research output: Contribution to journalArticle

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Abstract

Study objective We study the effect of a nationwide dispatcher-assisted cardiopulmonary resuscitation (CPR) program on out-of-hospital cardiac arrest outcomes by arrest location (public and private settings). Methods All emergency medical services (EMS)–treated adults in Korea with out-of-hospital cardiac arrests of cardiac cause were enrolled between 2012 and 2013, excluding cases witnessed by EMS providers and those with unknown outcomes. Exposure was bystander CPR categorized into 3 groups: bystander CPR with dispatcher assistance, bystander CPR without dispatcher assistance, and no bystander CPR. The endpoint was good neurologic recovery at discharge. Multivariable logistic regression analysis was performed. The final model with an interaction term was evaluated to compare the effects across settings. Results A total of 37,924 patients (31.1% bystander CPR with dispatcher assistance, 14.3% bystander CPR without dispatcher assistance, and 54.6% no bystander CPR) were included in the final analysis. The total bystander CPR rate increased from 30.9% in quarter 1 (2012) to 55.7% in quarter 4 (2014). Bystander CPR with and without dispatcher assistance was more likely to result in higher survival with good neurologic recovery (4.8% and 5.2%, respectively) compared with no bystander CPR (2.1%). The adjusted odds ratios for good neurologic recovery were 1.50 (95% confidence interval [CI] 1.30 to 1.74) in bystander CPR with dispatcher assistance and 1.34 (95% CI 1.12 to 1.60) in bystander CPR without it compared with no bystander CPR. For arrests in private settings, the adjusted odds ratios were 1.58 (95% CI 1.30 to 1.92) in bystander CPR with dispatcher assistance and 1.28 (95% CI 0.98 to 1.67) in bystander CPR without it; in public settings, the adjusted odds ratios were 1.41 (95% CI 1.14 to 1.75) and 1.37 (95% CI 1.08 to 1.72), respectively. Conclusion Bystander CPR regardless of dispatcher assistance was associated with improved neurologic recovery after out-of-hospital cardiac arrest. However, for out-of-hospital cardiac arrest cases in private settings, bystander CPR was associated with improved neurologic recovery only when dispatcher assistance was provided.

Original languageEnglish (US)
Pages (from-to)52-61.e1
JournalAnnals of Emergency Medicine
Volume69
Issue number1
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

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Out-of-Hospital Cardiac Arrest
Cardiopulmonary Resuscitation
Nervous System
Survival
Confidence Intervals
Odds Ratio
Emergency Medical Services

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Effect of Dispatcher-Assisted Cardiopulmonary Resuscitation Program and Location of Out-of-Hospital Cardiac Arrest on Survival and Neurologic Outcome. / Ro, Young Sun; Shin, Sang Do; Lee, Yu Jin; Lee, Seung Chul; Song, Kyoung Jun; Ryoo, Hyun Wook; Ong, Marcus Eng Hock; McNally, Bryan; Bobrow, Bentley J; Tanaka, Hideharu; Myklebust, Helge; Birkenes, Tonje Søraas.

In: Annals of Emergency Medicine, Vol. 69, No. 1, 01.01.2017, p. 52-61.e1.

Research output: Contribution to journalArticle

Ro, YS, Shin, SD, Lee, YJ, Lee, SC, Song, KJ, Ryoo, HW, Ong, MEH, McNally, B, Bobrow, BJ, Tanaka, H, Myklebust, H & Birkenes, TS 2017, 'Effect of Dispatcher-Assisted Cardiopulmonary Resuscitation Program and Location of Out-of-Hospital Cardiac Arrest on Survival and Neurologic Outcome', Annals of Emergency Medicine, vol. 69, no. 1, pp. 52-61.e1. https://doi.org/10.1016/j.annemergmed.2016.07.028
Ro, Young Sun ; Shin, Sang Do ; Lee, Yu Jin ; Lee, Seung Chul ; Song, Kyoung Jun ; Ryoo, Hyun Wook ; Ong, Marcus Eng Hock ; McNally, Bryan ; Bobrow, Bentley J ; Tanaka, Hideharu ; Myklebust, Helge ; Birkenes, Tonje Søraas. / Effect of Dispatcher-Assisted Cardiopulmonary Resuscitation Program and Location of Out-of-Hospital Cardiac Arrest on Survival and Neurologic Outcome. In: Annals of Emergency Medicine. 2017 ; Vol. 69, No. 1. pp. 52-61.e1.
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abstract = "Study objective We study the effect of a nationwide dispatcher-assisted cardiopulmonary resuscitation (CPR) program on out-of-hospital cardiac arrest outcomes by arrest location (public and private settings). Methods All emergency medical services (EMS)–treated adults in Korea with out-of-hospital cardiac arrests of cardiac cause were enrolled between 2012 and 2013, excluding cases witnessed by EMS providers and those with unknown outcomes. Exposure was bystander CPR categorized into 3 groups: bystander CPR with dispatcher assistance, bystander CPR without dispatcher assistance, and no bystander CPR. The endpoint was good neurologic recovery at discharge. Multivariable logistic regression analysis was performed. The final model with an interaction term was evaluated to compare the effects across settings. Results A total of 37,924 patients (31.1{\%} bystander CPR with dispatcher assistance, 14.3{\%} bystander CPR without dispatcher assistance, and 54.6{\%} no bystander CPR) were included in the final analysis. The total bystander CPR rate increased from 30.9{\%} in quarter 1 (2012) to 55.7{\%} in quarter 4 (2014). Bystander CPR with and without dispatcher assistance was more likely to result in higher survival with good neurologic recovery (4.8{\%} and 5.2{\%}, respectively) compared with no bystander CPR (2.1{\%}). The adjusted odds ratios for good neurologic recovery were 1.50 (95{\%} confidence interval [CI] 1.30 to 1.74) in bystander CPR with dispatcher assistance and 1.34 (95{\%} CI 1.12 to 1.60) in bystander CPR without it compared with no bystander CPR. For arrests in private settings, the adjusted odds ratios were 1.58 (95{\%} CI 1.30 to 1.92) in bystander CPR with dispatcher assistance and 1.28 (95{\%} CI 0.98 to 1.67) in bystander CPR without it; in public settings, the adjusted odds ratios were 1.41 (95{\%} CI 1.14 to 1.75) and 1.37 (95{\%} CI 1.08 to 1.72), respectively. Conclusion Bystander CPR regardless of dispatcher assistance was associated with improved neurologic recovery after out-of-hospital cardiac arrest. However, for out-of-hospital cardiac arrest cases in private settings, bystander CPR was associated with improved neurologic recovery only when dispatcher assistance was provided.",
author = "Ro, {Young Sun} and Shin, {Sang Do} and Lee, {Yu Jin} and Lee, {Seung Chul} and Song, {Kyoung Jun} and Ryoo, {Hyun Wook} and Ong, {Marcus Eng Hock} and Bryan McNally and Bobrow, {Bentley J} and Hideharu Tanaka and Helge Myklebust and Birkenes, {Tonje S{\o}raas}",
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T1 - Effect of Dispatcher-Assisted Cardiopulmonary Resuscitation Program and Location of Out-of-Hospital Cardiac Arrest on Survival and Neurologic Outcome

AU - Ro, Young Sun

AU - Shin, Sang Do

AU - Lee, Yu Jin

AU - Lee, Seung Chul

AU - Song, Kyoung Jun

AU - Ryoo, Hyun Wook

AU - Ong, Marcus Eng Hock

AU - McNally, Bryan

AU - Bobrow, Bentley J

AU - Tanaka, Hideharu

AU - Myklebust, Helge

AU - Birkenes, Tonje Søraas

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Study objective We study the effect of a nationwide dispatcher-assisted cardiopulmonary resuscitation (CPR) program on out-of-hospital cardiac arrest outcomes by arrest location (public and private settings). Methods All emergency medical services (EMS)–treated adults in Korea with out-of-hospital cardiac arrests of cardiac cause were enrolled between 2012 and 2013, excluding cases witnessed by EMS providers and those with unknown outcomes. Exposure was bystander CPR categorized into 3 groups: bystander CPR with dispatcher assistance, bystander CPR without dispatcher assistance, and no bystander CPR. The endpoint was good neurologic recovery at discharge. Multivariable logistic regression analysis was performed. The final model with an interaction term was evaluated to compare the effects across settings. Results A total of 37,924 patients (31.1% bystander CPR with dispatcher assistance, 14.3% bystander CPR without dispatcher assistance, and 54.6% no bystander CPR) were included in the final analysis. The total bystander CPR rate increased from 30.9% in quarter 1 (2012) to 55.7% in quarter 4 (2014). Bystander CPR with and without dispatcher assistance was more likely to result in higher survival with good neurologic recovery (4.8% and 5.2%, respectively) compared with no bystander CPR (2.1%). The adjusted odds ratios for good neurologic recovery were 1.50 (95% confidence interval [CI] 1.30 to 1.74) in bystander CPR with dispatcher assistance and 1.34 (95% CI 1.12 to 1.60) in bystander CPR without it compared with no bystander CPR. For arrests in private settings, the adjusted odds ratios were 1.58 (95% CI 1.30 to 1.92) in bystander CPR with dispatcher assistance and 1.28 (95% CI 0.98 to 1.67) in bystander CPR without it; in public settings, the adjusted odds ratios were 1.41 (95% CI 1.14 to 1.75) and 1.37 (95% CI 1.08 to 1.72), respectively. Conclusion Bystander CPR regardless of dispatcher assistance was associated with improved neurologic recovery after out-of-hospital cardiac arrest. However, for out-of-hospital cardiac arrest cases in private settings, bystander CPR was associated with improved neurologic recovery only when dispatcher assistance was provided.

AB - Study objective We study the effect of a nationwide dispatcher-assisted cardiopulmonary resuscitation (CPR) program on out-of-hospital cardiac arrest outcomes by arrest location (public and private settings). Methods All emergency medical services (EMS)–treated adults in Korea with out-of-hospital cardiac arrests of cardiac cause were enrolled between 2012 and 2013, excluding cases witnessed by EMS providers and those with unknown outcomes. Exposure was bystander CPR categorized into 3 groups: bystander CPR with dispatcher assistance, bystander CPR without dispatcher assistance, and no bystander CPR. The endpoint was good neurologic recovery at discharge. Multivariable logistic regression analysis was performed. The final model with an interaction term was evaluated to compare the effects across settings. Results A total of 37,924 patients (31.1% bystander CPR with dispatcher assistance, 14.3% bystander CPR without dispatcher assistance, and 54.6% no bystander CPR) were included in the final analysis. The total bystander CPR rate increased from 30.9% in quarter 1 (2012) to 55.7% in quarter 4 (2014). Bystander CPR with and without dispatcher assistance was more likely to result in higher survival with good neurologic recovery (4.8% and 5.2%, respectively) compared with no bystander CPR (2.1%). The adjusted odds ratios for good neurologic recovery were 1.50 (95% confidence interval [CI] 1.30 to 1.74) in bystander CPR with dispatcher assistance and 1.34 (95% CI 1.12 to 1.60) in bystander CPR without it compared with no bystander CPR. For arrests in private settings, the adjusted odds ratios were 1.58 (95% CI 1.30 to 1.92) in bystander CPR with dispatcher assistance and 1.28 (95% CI 0.98 to 1.67) in bystander CPR without it; in public settings, the adjusted odds ratios were 1.41 (95% CI 1.14 to 1.75) and 1.37 (95% CI 1.08 to 1.72), respectively. Conclusion Bystander CPR regardless of dispatcher assistance was associated with improved neurologic recovery after out-of-hospital cardiac arrest. However, for out-of-hospital cardiac arrest cases in private settings, bystander CPR was associated with improved neurologic recovery only when dispatcher assistance was provided.

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