Abstract
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.
Keywords
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Article info
Publication history
Published online: December 29, 2021
Accepted:
December 24,
2021
Received in revised form:
November 18,
2021
Received:
June 8,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
