首页|International multi-center real world implementation trial to increase out-of-hospital cardiac arrest survival with a dispatcher-assisted cardio-pulmonary resuscitation package (Pan-Asian resuscitation outcomes study phase 2)

International multi-center real world implementation trial to increase out-of-hospital cardiac arrest survival with a dispatcher-assisted cardio-pulmonary resuscitation package (Pan-Asian resuscitation outcomes study phase 2)

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  • NSTL
  • Elsevier
? 2021 Elsevier B.V.Background: Dispatcher-assisted CPR (DA-CPR) has the potential to deliver early bystander CPR (BCPR) and improve out-of-hospital cardiac arrest (OHCA) survival. This study in the Asia-Pacific evaluated the impact of a DA-CPR program on BCPR rates and survival. Methods: This was a three-arm, prospective, multi-national, population-based, community-level, implementation trial. Cases between January 2009 and June 2018 from the Pan-Asian Resuscitation Outcomes Study were included. Sites either implemented a comprehensive (with quality improvement tool) or a basic DA-CPR package, or served as controls. Primary outcome was survival-to-discharge/30th day post-arrest. Secondary outcomes were BCPR and favorable neurological outcome. A before-after comparison was made within each country; this before-after change was then compared across the three groups using logistic regression. Results: 170,687 cases were analyzed. Before-after comparison showed that survival to discharge was higher in the ‘implementation’ period in all three groups: comprehensive odds ratio (OR) 1.09, 95% confidence interval (CI; [1.0–1.19]); basic OR 1.14, 95% CI (1.08–1.2); and control OR 1.25, 95% CI (1.02–1.53). Comparing between groups, the comprehensive group had significantly higher change in BCPR (comprehensive vs control ratio of OR 1.86, 95% CI [1.66–2.09]; basic vs control ratio of OR 0.94, 95% CI [0.85–1.05]; and comprehensive vs basic ratio of OR 1.97, 95% CI [1.87–2.08]) and survival with favorable neurological outcome (comprehensive vs basic ratio of OR 1.2, 95% CI [1.04–1.39]). Conclusion: We evaluated the impact of a DA-CPR program across heterogeneous EMS systems and demonstrated that a comprehensive DA-CPR program had the most impact on BCPR and favorable neurological outcome.

Asia-PacificBystander CPRCardiopulmonary resuscitationDispatcher-assisted CPREmergency medical servicesdispatchOut-of-hospital cardiac arrestRegistryTelephone CPR

Shin S.D.、Ko P.C.-I.、Lin X.、Ma M.H.-M.、Ryoo H.W.、Wong K.D.、Supasaowapak J.、Lin C.-H.、Kuo C.-W.、Ong M.E.H.、Rao R.、Cai W.、Gaerlan F.J.、Khursheed M.、Son D.N.、Sarah K.、El Sayed M.、Al Qahtani S.、Tanaka H.

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Department of Emergency Medicine Seoul National University College of Medicine

Department of Emergency Medicine National Taiwan University Hospital College of Medicine National

Singapore Clinical Research Institute

Department of Emergency Medicine National Taiwan University Hospital Yunlin Branch

Department of Emergency Medicine Kyungpook National University Hospital School of Medicine

Emergency Department Hospital Pulau Pinang

Department of Emergency Medicine Rajavithi Hospital

Department of Emergency Medicine National Cheng Kung University Hospital College of Medicine

Department of Emergency Medicine Chang-Gung Memorial Hospital

Prehospital and Emergency Research Centre Health Services & Systems Research Duke-NUS Medical School

GVK Emergency Management and Research Institute (GVK EMRI)

Department of Emergency Medicine Zhejiang Provincial People's Hospital

Southern Philippines Medical Center

Emergency Department National Institute of Cardiovascular Diseases

Center for Emergency Medicine Bach Mai Hospital

Department of Emergency Medicine Hospital Sungai Buloh

Department of Emergency Medicine American University of Beirut Medical Center

National Ambulance

Department of EMS System Graduate School Kokushikan University

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2022

10.1016/j.resuscitation.2021.12.032

Resuscitation.

Resuscitation.

ISSN：0300-9572
年,卷(期)：2022.171
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