Abstract 121: Quality of Cardiopulmonary Resuscitation by Bystanders and Survival After Out-of-Hospital Cardiac Arrest

Abstract

Introduction: Although quality of cardiopulmonary resuscitation (CPR) is a key to increase survival after out-of-hospital cardiac arrest (OHCA), little is known about the quality of bystander CPR and its association with survival outcomes after OHCA. Objective: To evaluate the association of quality of bystander CPR and patient outcomes after OHCA. Methods: Designs: Population-based cohort study. Cases: All OHCA cases treated by emergency medical services (EMS) personnel in Toyonaka city between September 2011 and August 2013. Data collection and analyses: EMS personnel assessed bystanders’ CPR quality including hand position, depth, and tempo of chest compressions using a specific data form at the scene. Fleiss’ Kappa statistics was used to assess the evaluation reliability among EMS personnel and the Kappa value was 0.81 before the study. The primary outcome was patient one-month survival with favorable neurological outcome and it was compared between the good-quality CPR group and the poor-quality CPR group. Results: Among 877 cases, bystander CPR was attempted in 429 (48.9%). Data on quality of CPR was applicable in 272 (63.4%) of them. In the good-quality CPR group, bystanders were younger, more likely to be health care provider, and have experience of CPR training than in the poor-quality of CPR group. The proportion of patients with neurologically favorable one-month survival was somewhat greater in the good-quality of CPR group (4.6% versus 3.0%), although it was statistically insignificant. Conclusions: Better quality of bystander chest compressions might increase OHCA patient survival. Further efforts to improve quality of CPR by general public are needed.