• Filip Gnesin, Amalie Lykkemark Møller, Elisabeth Helen Anna Mills, Nertila Zylyftari, Britta Jensen, Henrik Bøggild, RinggrenKristian BundgaardKBDepartment of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark., Stig Nikolaj Fasmer Blomberg, ChristensenHelle CollatzHCCopenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, 2750 Ballerup, Denmark; Danish Clinical Quality Program (RKKP), National Clinical Registries, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark., Kristian Kragholm, Freddy Lippert, Fredrik Folke, and Christian Torp-Pedersen.
• Department of Cardiology, Nordsjællands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark. Electronic address: filip.gnesin@gmail.com.
• Resuscitation. 2021 Jun 1; 163: 176-183.

AimAs proxy for initiation of the first link in the Chain of Survival by the dispatcher, we aimed to investigate the effect of time to first dispatch on 30-day survival among patients with OHCA ultimately receiving the highest-level emergency medical response.MethodsWe linked data on all OHCA unwitnessed by emergency medical services (EMS) treated by Copenhagen EMS from 2016 through 2018 to corresponding emergency call records. Among patients receiving highest priority emergency response, we calculated time to dispatch as time from start of call to time of first dispatch.ResultsWe included 3548 patients with OHCA. Of these, 94.1% received the highest priority response (median time to dispatch 0.84 min, 25th-75th percentile 0.58-1.24 min). Patients with time to dispatch within one minute compared to three or more minutes were more likely to receive bystander cardiopulmonary resuscitation (77.3 vs 54.2%), bystander defibrillation (11.5 vs 6.5%) and defibrillation by emergency medical services (24.1 vs 7.5%) and were 2.6-fold more likely to survive 30 days after the OHCA (P = 0.004). Results from multivariate logistic regression were similar: odds ratio (OR) of survival 0.83 per minute increase (95% confidence interval 0.70-1.00, P = 0.04). However, survival was similar between those who received highest priority response and those who did not: OR of survival 0.88 (95% confidence interval 0.53-1.46, P = 0.61).ConclusionRapid time to dispatch among patients with highest priority response was significantly associated with a higher probability of 30-day survival following OHCA.Copyright © 2021 Elsevier B.V. All rights reserved.

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