Effect of bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients in Sweden

• Published in: Resuscitation 2000-09, Vol.47 (1), p.59-70
• Main Authors: Holmberg, Mikael, Holmberg, Stig, Herlitz, Johan
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bystander cardiopulmonary resuscitation; Cardiac arrest patients; Cardiopulmonary Resuscitation; Electrocardiography; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Health Personnel; Heart Arrest - physiopathology; Heart Arrest - therapy; Hospitalization; Humans; Incidence; Intensive care medicine; Medical sciences; Odds Ratio; Prospective Studies; Survival Analysis; Sweden; Time Factors; Treatment Outcome; Ventricular Fibrillation - epidemiology
• ISSN: 0300-9572; 1873-1570; 1873-1570
• DOI: 10.1016/S0300-9572(00)00199-4

Background: Information from the Swedish Cardiac Arrest Registry was used to investigate: (a) The proportion of patients suffering an out-of-hospital cardiac arrest who were given bystander cardiopulmonary resuscitation (B-CPR). (b) Where and by whom B-CPR was given. (c) The effect of B-CPR on survival. Method: a prospective, observational study of cardiac arrests reported to the Swedish Cardiac Arrest Registry. Analyses were based on standardised reports of out-of-hospital cardiac arrests from ambulance organisations in Sweden, serving 60% of the Swedish population. From 1983 to 1995 ∼15–20% of the population had been trained in CPR. Results: Of 9877 patients, collected between January 1990 and May 1995, B-CPR was attempted in 36%. In 56% of these cases, the bystanders were lay persons and in 25% they were medical personnel. Most of the arrests took place at home (69%) and only 23% of these patients were given B-CPR in contrast to cardiac arrest in other places where 53% were given CPR. Survival to 1 month was significantly higher in all cases that received B-CPR (8.2 vs. 2.5%). The odds ratio for survival to 1 month with B-CPR was in a logistic regression analysis 2.5 (95% CI 1.9–3.1). Conclusions: in Sweden, the willingness and ability to perform B-CPR appears to be relatively widespread. More than half of B-CPR was performed by laypersons. B-CPR resulted in a two to threefold increase in survival.