The effect of video-instructed versus audio-instructed dispatcher-assisted cardiopulmonary resuscitation on patient outcomes following out of hospital cardiac arrest in Seoul

Hee Soon Lee,Kicheol You,Chulho Kim,Sungeun Kim,Jin Pyeong Jeon

doi:10.1038/s41598-021-95077-5

Hee Soon Lee, Kicheol You + Show 3 more

Open Access

https://doi.org/10.1038/s41598-021-95077-5

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Journal: Scientific Reports	Publication Date: Jul 30, 2021
Citations: 12	License type: open-access

Affiliation: Hallym University

Abstract

We aimed to investigate whether video-instructed dispatcher-assisted (DA)-cardiopulmonary resuscitation (CPR) improved neurologic recovery and survival to discharge compared to audio-instructed DA-CPR in adult out-of-hospital cardiac arrest (OHCA) patients in a metropolitan city with sufficient experience and facilities. A retrospective cohort study was conducted for adult bystander-witnessed OHCA patients administered DA-CPR due to presumed cardiac etiology between January 1, 2018 and October 31, 2019 in Seoul, Korea. The primary and secondary outcomes were the differences in favorable neurologic outcome and survival to discharge rates in adult OHCA patients in the two instruction groups. Binary logistic regression analysis was performed to identify the outcome predictors after DA-CPR. A total of 2109 adult OHCA patients with DA-CPR were enrolled. Numbers of elderly patients in audio instruction and video instruction were 1260 (73.2%) and 214 (55.3%), respectively. Elderly patients and those outside the home or medical facility were more likely to receive video instruction. Favorable neurologic outcome was observed more in patients who received video-instructed DA-CPR (n = 75, 19.4%) than in patients who received audio-instructed DA-CPR (n = 117, 6.8%). The survival to discharge rate was also higher in video-instructed DA-CPR (n = 105, 27.1%) than in audio-instructed DA-CPR (n = 211, 12.3%). Video-instructed DA-CPR was significantly associated with neurologic recovery (aOR = 2.11, 95% CI 1.48–3.01) and survival to discharge (aOR = 1.81, 95% CI 1.33–2.46) compared to audio-instructed DA-CPR in adult OHCA patients after adjusting for age, gender, underlying diseases and CPR location. Video-instructed DA-CPR was associated with favorable outcomes in adult patients with OHCA in a metropolitan city equipped with sufficient experience and facilities.

Highlights

Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of death and millions of people each year die from OHCA
We aimed to investigate whether video-instructed DA-cardiopulmonary resuscitation (CPR) resulted in improved neurologic recovery and survival to discharge compared to audio-instructed Dispatcherassisted CPR (DA-CPR) in a city setting
A total of 5041 cases of OHCA assessed by emergency medical service (EMS) were collected after screening the initial data from the Seoul Emergency Operation Center

Summary

Introduction

Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of death and millions of people each year die from OHCA. Lee et al.[5] reported early clinical experience with video-instructed DA-CPR and analyzed the survival outcomes compared to those from audio-instructed CPR in Seoul, a metropolitan city in Korea, between January and December in 2017 In their study, video-instructed DA-CPR was associated with a higher rate of survival to discharge and favorable neurologic outcomes via unadjusted analysis. This relationship was not statistically significant in the adjusted analysis. We aimed to investigate whether video-instructed DA-CPR resulted in improved neurologic recovery and survival to discharge compared to audio-instructed DA-CPR in a city setting

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