Duration of cardiopulmonary resuscitation in patients without prehospital return of spontaneous circulation after out-of-hospital cardiac arrest: Results from a severity stratification analysis

• Published in: Resuscitation 2018-03, Vol.124, p.69-75
• Main Authors: Funada, Akira, Goto, Yoshikazu, Tada, Hayato, Teramoto, Ryota, Shimojima, Masaya, Hayashi, Kenshi, Kawashiri, Masa-aki, Yamagishi, Masakazu
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - methods; Cardiopulmonary Resuscitation - mortality; Electric Countershock - methods; Electric Countershock - mortality; Emergency Medical Services - methods; Epidemiology; Female; Humans; Japan - epidemiology; Male; Middle Aged; Out-of-hospital cardiac arrest; Out-of-Hospital Cardiac Arrest - classification; Out-of-Hospital Cardiac Arrest - mortality; Outcome Assessment (Health Care); Population Surveillance; Prospective Studies; Registries; Time Factors
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2018.01.008

The relationship between duration of cardiopulmonary resuscitation (CPR) and post-arrest outcomes based on severity stratification in out-of-hospital cardiac arrest (OHCA) patients without prehospital return of spontaneous circulation (ROSC) remains unclear. We analysed 420,959 adult patients without prehospital ROSC in the All-Japan OHCA registry for 4 years. Prehospital CPR duration was defined as the time from CPR initiation by emergency medical service (EMS) providers to hospital arrival. The primary outcome was 1-month neurologically intact survival (cerebral performance category 1 or 2, CPC 1–2). The rate of overall 1-month CPC 1–2 was 0.45% (1899/420,959). Using recursive partitioning analysis to predict 1-month CPC 1–2, we stratified patients into 4 groups with 3 predictors: patients aged