Abstract
SESSION TITLE: Monday Electronic Posters 2 SESSION TYPE: Original Inv Poster Discussion PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM PURPOSE: Drowning is an important public health issue as approximately 1.5 people die from drowning every minute of every day around the world. Great emphasis has been placed on rescue breathing in out-of-hospital cardiac arrest (OHCA) due to drowning. However, there is no evidence about the effect of rescue breathing on neurologically favorable survival after OHCA due to drowning neither in randomized clinical trials nor observational studies. The aim of this study is to compare the effect of conventional (with rescue breathing) versus compression-only (without rescue breathing) cardiopulmonary resuscitation (CPR) in OHCA due to drowning. METHODS: This nationwide population-based observational study using prospectively collected government-led registry data included patients with OHCA due to drowning who were transported to an emergency hospital in Japan between 2013 and 2016. The primary outcome was one-month neurologically favorable survival defined as Glasgow-Pittsburgh Cerebral Performance Category score of 1 or 2. The secondary outcomes were one-month overall survival and prehospital return of spontaneous circulation (ROSC). RESULTS: The full cohort (n=5,121) comprised 2,486 (48.5%) male patients, and the mean age was 72.4 (standard deviation [SD], 21.6). Of these, 968 (18.9%) received conventional CPR, and 4,153 (81.1%) received compression-only CPR. 928 patients receiving conventional CPR were propensity-matched with 928 patients receiving compression-only CPR. In the propensity score-matched cohort, one-month neurologically favorable survival (7.5% vs. 6.6%; risk ratio [RR], 1.15; 95% confidence interval [CI], 0.82-1.60; P=0.4147), one-month overall survival (10.5% vs. 8.6%; RR, 1.21; 95%CI, 0.91-1.61; P=0.1791), and prehospital ROSC (10.6% vs. 8.9%; RR, 1.18; 95%CI, 0.89-1.56; P=0.2405) were not significantly different. This association was consistent across a variety of subgroup analyses. CONCLUSIONS: Among patients with OHCA due to drowning, there were no differences in one-month neurologically favorable survival, one-month overall survival, and prehospital ROSC between conventional and compression-only CPR. CLINICAL IMPLICATIONS: Our data suggest that compression-only CPR may be as lifesaving as conventional CPR in OHCA due to drowning. Considering that the simplicity of compression-only CPR to teach, learn, remember, and perform can improve the implementation rate of bystander CPR, compression-only CPR may be an attractive option even in OHCA due to drowning. An adequately powered RCT is required to determine the equivalence or superiority between conventional and compression-only CPR in OHCA due to drowning. DISCLOSURES: No relevant relationships by Tatsuma Fukuda, source=Web Response no disclosure on file for Kei Hayashida; No relevant relationships by YUTAKA KONDO, source=Web Response No relevant relationships by ICHIRO KUKITA, source=Web Response no disclosure on file for Naoko Ohashi-Fukuda
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