• Min Woo Kim, Tae Han Kim, Kyoung Jun Song, Sang Do Shin, Chu Hyun Kim, Eui Jung Lee, and Kihong Kim.
• Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea. Electronic address: snuheros@gmail.com.
• Resuscitation. 2021 Jan 1; 158: 64-70.

IntroductionBystander cardiopulmonary resuscitation (CPR) is an important prognostic factor for outcome in out-of-hospital cardiac arrest (OHCA). The dispatcher-assisted (DA) bystander CPR program has increased the rate of bystander CPR by targeting bystanders with a lower level of CPR training. We evaluated the effects of dispatcher-assisted bystander CPR and self-led bystander CPR.MethodsA retrospective analysis was performed using a nationwide OHCA database from 2014 to 2018. Adult EMS-treated OHCA patients with presumed cardiac origin were enrolled. OHCAs were classified into 3 groups according to the type of bystander CPR (DA bystander CPR vs. self-led bystander CPR vs. no bystander CPR) provided. The primary outcome was good neurologic recovery at hospital discharge. A multivariable logistic regression model was used to estimate the association between the type of bystander CPR and outcomes.ResultsA total of 91,557 eligible OHCA patients was enrolled in the final analysis. The proportion of patients with favorable neurologic outcomes was highest with self-led bystander CPR (9.0% for self-led bystander CPR, 5.2% for DA bystander CPR and 3.2% for no bystander CPR, p < 0.01). Self-led bystander CPR was associated with better neurological recovery than DA bystander CPR (aOR with 95% CI (DA-CPR as reference): 0.63 (0.58-0.69) for no bystander CPR, 1.28 (1.17-1.40) for self-led bystander CPR).ConclusionAlthough DA CPR was associated with better neurologic outcomes than no bystander CPR, good neurologic outcomes were most strongly associated with self-led bystander CPR.Copyright © 2020. Published by Elsevier B.V.

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