DOI: 10.1161/CIRCULATIONAHA.114.014905
Dissemination of Chest Compression-Only Cardiopulmonary Resuscitation and Survival After Out-of-Hospital Cardiac Arrest
Running title: Iwami et al.; Compression-only CPR and Survival from OHCA
Taku Iwami, MD, MPH, PhD1*; Tetsuhisa Kitamura, MD, MS, DPH2*; Kosuke Kiyohara, DPH3*; Takashi Kawamura, MD, PhD1
1
Kyoto University Health Service, Kyoto, Japan; 2Division of Environmental Medicine and
Popu Population pu ula lati tion ti on Sciences, Sci c en nce ces, Dept of Social and Environmental Environm nmen nm e tal Medicine, Graduate Grad adua ad u te School of Medicine, Medicine Osaka Os University, Univerrsi sity ty, Su Suit Suita, ita, it a, Japan; Jap apan an;; 3De an Dept pt off Pu Publ Public b ic H Health, ealt lth, lt h, T Tokyo okyo ok yo W Women’s omen om en’s M Medical edic ed ical ic al U University, nive ni vers ve rsit rs ityy, it Tokyo, To okyo, Ja Japan apan an *contributed *c con ontr trib tr ibut ib uted ut ed eequally qual qu ally al ly
Address for Correspondence: Taku Iwami, MD, PhD Kyoto University Health Service Yoshida-Honmachi, Sakyo-ku Kyoto 606-8501, Japan Tel: +81-75-753-2401 Fax: +81-75-753-2424 E-mail: [email protected]
Journal Subject Code: Etiology:[8] Epidemiology
1 Downloaded from http://circ.ahajournals.org/ at CONS CALIFORNIA DIG LIB on June 5, 2015
DOI: 10.1161/CIRCULATIONAHA.114.014905
Abstract
Background—The best cardiopulmonary resuscitation (CPR) technique for survival after out-ofhospital cardiac arrests (OHCAs) has been intensively discussed in the recent few years. However, most analyses focused on comparison at individual level and how well the dissemination of bystander-initiated chest compression-only CPR (CCCPR) increases survival after OHCAs at the population level remains unclear. We therefore evaluated the impact of nationwide dissemination of bystander-initiated CCCPR on the survival after OHCA. Methods and Results—A nationwide, prospective, population-based observational study covering the whole population of Japan and involving consecutive OHCA patients with resuscitation attempts was conducted from January 2005 through December 2012. The main outcome measure was one-month survival with favorable neurologic outcome. Thee in inci ide denc ncee of nc o incidence urvival with favorable neurologic outcome attributed by types of bystander CPR R (C (CCC CCPR CC PR aand nd survival (CCCPR conventional CPR with rescue breathing) was estimated. Among 816,385 OHCAs before emer errge genc ncync y-me ym diicaal-services arrival, 249,970 (30 0.6 .6%) 6% received CCCPR, R, 100,469 (12.3%) emergency-medical-services (30.6%) co onv nventionall C PR, an PR nd 46 465, 5 9446 (5 (57. 7 1% 1%)) no C PR. T he pr prop opor op o tiion ooff OH or OHCA C patients pat atie ient ie ntss receiving nt rece ceiv ce ivin iv ingg in conventional CPR, and 465,946 (57.1%) CPR. The proportion C CP CC C R or any C PR (e eitther C C PR orr cconventional CC onvvenntiona naal CP PR) bby y by ysttandeerss in ncrreased d ffrom rom 17.4 4% CCCPR CPR (either CCCPR CPR) bystanders increased 17.4% o 339.3% 9.3% 9. 3% ((P P for forr trend tren endd
Dissemination of Chest Compression-Only Cardiopulmonary Resuscitation and Survival After Out-of-Hospital Cardiac Arrest
Running title: Iwami et al.; Compression-only CPR and Survival from OHCA
Taku Iwami, MD, MPH, PhD1*; Tetsuhisa Kitamura, MD, MS, DPH2*; Kosuke Kiyohara, DPH3*; Takashi Kawamura, MD, PhD1
1
Kyoto University Health Service, Kyoto, Japan; 2Division of Environmental Medicine and
Popu Population pu ula lati tion ti on Sciences, Sci c en nce ces, Dept of Social and Environmental Environm nmen nm e tal Medicine, Graduate Grad adua ad u te School of Medicine, Medicine Osaka Os University, Univerrsi sity ty, Su Suit Suita, ita, it a, Japan; Jap apan an;; 3De an Dept pt off Pu Publ Public b ic H Health, ealt lth, lt h, T Tokyo okyo ok yo W Women’s omen om en’s M Medical edic ed ical ic al U University, nive ni vers ve rsit rs ityy, it Tokyo, To okyo, Ja Japan apan an *contributed *c con ontr trib tr ibut ib uted ut ed eequally qual qu ally al ly
Address for Correspondence: Taku Iwami, MD, PhD Kyoto University Health Service Yoshida-Honmachi, Sakyo-ku Kyoto 606-8501, Japan Tel: +81-75-753-2401 Fax: +81-75-753-2424 E-mail: [email protected]
Journal Subject Code: Etiology:[8] Epidemiology
1 Downloaded from http://circ.ahajournals.org/ at CONS CALIFORNIA DIG LIB on June 5, 2015
DOI: 10.1161/CIRCULATIONAHA.114.014905
Abstract
Background—The best cardiopulmonary resuscitation (CPR) technique for survival after out-ofhospital cardiac arrests (OHCAs) has been intensively discussed in the recent few years. However, most analyses focused on comparison at individual level and how well the dissemination of bystander-initiated chest compression-only CPR (CCCPR) increases survival after OHCAs at the population level remains unclear. We therefore evaluated the impact of nationwide dissemination of bystander-initiated CCCPR on the survival after OHCA. Methods and Results—A nationwide, prospective, population-based observational study covering the whole population of Japan and involving consecutive OHCA patients with resuscitation attempts was conducted from January 2005 through December 2012. The main outcome measure was one-month survival with favorable neurologic outcome. Thee in inci ide denc ncee of nc o incidence urvival with favorable neurologic outcome attributed by types of bystander CPR R (C (CCC CCPR CC PR aand nd survival (CCCPR conventional CPR with rescue breathing) was estimated. Among 816,385 OHCAs before emer errge genc ncync y-me ym diicaal-services arrival, 249,970 (30 0.6 .6%) 6% received CCCPR, R, 100,469 (12.3%) emergency-medical-services (30.6%) co onv nventionall C PR, an PR nd 46 465, 5 9446 (5 (57. 7 1% 1%)) no C PR. T he pr prop opor op o tiion ooff OH or OHCA C patients pat atie ient ie ntss receiving nt rece ceiv ce ivin iv ingg in conventional CPR, and 465,946 (57.1%) CPR. The proportion C CP CC C R or any C PR (e eitther C C PR orr cconventional CC onvvenntiona naal CP PR) bby y by ysttandeerss in ncrreased d ffrom rom 17.4 4% CCCPR CPR (either CCCPR CPR) bystanders increased 17.4% o 339.3% 9.3% 9. 3% ((P P for forr trend tren endd
