• Resuscitation · Feb 2022

    International Multi-Center Real World Implementation Trial to Increase Out-of-Hospital Cardiac Arrest Survival with a Dispatcher-Assisted Cardio-Pulmonary Resuscitation Package (Pan-Asian Resuscitation Outcomes Study Phase 2).

    • OngMarcus Eng HockMEHPrehospital and Emergency Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore; Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore. Electronic address: ma, Sang Do Shin, Patrick Chow-In Ko, Xinyi Lin, Matthew Huei-Ming Ma, Hyun Wook Ryoo, Kwanhathai Darin Wong, Jirapong Supasaowapak, Chih-Hao Lin, Chan-Wei Kuo, Ramana Rao, Wenwei Cai, Faith Joan Gaerlan, Munawar Khursheed, Do Ngoc Son, Karim Sarah, Mazen El Sayed, Saad Al Qahtani, and Hideharu Tanaka.
    • Prehospital and Emergency Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore; Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore. Electronic address: marcus.ong@duke-nus.edu.sg.
    • Resuscitation. 2022 Feb 1; 171: 80-89.

    BackgroundDispatcher-assisted CPR (DA-CPR) has the potential to deliver early bystander CPR (BCPR) and improve out-of-hospital cardiac arrest (OHCA) survival. This study in the Asia-Pacific evaluated the impact of a DA-CPR program on BCPR rates and survival.MethodsThis was a three-arm, prospective, multi-national, population-based, community-level, implementation trial. Cases between January 2009 and June 2018 from the Pan-Asian Resuscitation Outcomes Study were included. Sites either implemented a comprehensive (with quality improvement tool) or a basic DA-CPR package, or served as controls. Primary outcome was survival-to-discharge/30th day post-arrest. Secondary outcomes were BCPR and favorable neurological outcome. A before-after comparison was made within each country; this before-after change was then compared across the three groups using logistic regression.Results170,687 cases were analyzed. Before-after comparison showed that survival to discharge was higher in the 'implementation' period in all three groups: comprehensive odds ratio (OR) 1.09, 95% confidence interval (CI; [1.0-1.19]); basic OR 1.14, 95% CI (1.08-1.2); and control OR 1.25, 95% CI (1.02-1.53). Comparing between groups, the comprehensive group had significantly higher change in BCPR (comprehensive vs control ratio of OR 1.86, 95% CI [1.66-2.09]; basic vs control ratio of OR 0.94, 95% CI [0.85-1.05]; and comprehensive vs basic ratio of OR 1.97, 95% CI [1.87-2.08]) and survival with favorable neurological outcome (comprehensive vs basic ratio of OR 1.2, 95% CI [1.04-1.39]).ConclusionWe evaluated the impact of a DA-CPR program across heterogeneous EMS systems and demonstrated that a comprehensive DA-CPR program had the most impact on BCPR and favorable neurological outcome.Copyright © 2021 Elsevier B.V. All rights reserved.

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