• Tetsuo Yamaguchi, Michikazu Nakai, Takahide Kodama, Masanari Kuwabara, Naohiro Yonemoto, Takanori Ikeda, Yoshio Tahara, and behalf of Japanese Circulation Society Resuscitation Science Study JCS-ReSS Group.
• Department of Cardiovascular Center, Toranomon Hospital, Tokyo 105-8470, Japan; Japanese Circulation Society Resuscitation Science Study (JCS-ReSS) Group. Electronic address: tetsuo5672@yahoo.co.jp.
• Resuscitation. 2024 Feb 1; 195: 110116110116.

BackgroundThe impact of a national initiative to provide cardiopulmonary resuscitation (CPR) education to the public on the rates of citizen-initiated CPR and survival following out-of-hospital cardiac arrest (OHCA) remains uncertain.MethodsWe examined 358,025 cases of citizen-witnessed OHCA with presumed cardiac origin, recorded in the Japanese nationwide registry from 2005 to 2020. We assessed the relationship between the number of individuals certified in CPR courses, citizen interventions, and neurologically favorable survival at one month.ResultsThe cumulative number of certified citizens has linearly increased from 9,930,327 in 2005 to 34,938,322 in 2020 (incidence rate ratio for annual number = 1.03, p < 0.001), encompassing 32.3% of the Japanese population aged 15 and above. Similarly, the prevalence of citizen-initiated CPR has consistently increased from 40.6% in 2005 to 56.8% in 2020 (P for trend < 0.001). Greater citizen CPR engagement was significantly associated with better outcome in initial shockable rhythm patients [chest compression only: odds ratio (OR) 1.24; 95% confidence interval (CI) 1.02-1.51; P = 0.029; chest compression with rescue breathing: OR 1.33; 95% CI 1.08-1.62; P = 0.006; defibrillation with chest compression: OR 2.27; 95% CI 1.83-2.83; P < 0.001; defibrillation with chest compression and rescue breathing: OR 2.15; 95% CI 1.70-2.73; P < 0.001 vs. no citizen CPR].ConclusionsThe incidence of citizen-initiated CPR across Japan has consistently and proportionately increased with the rising number of individuals certified in CPR courses. Greater citizen CPR involvement has been linked to neurologically favorable survival, particularly in cases with an initial shockable rhythm.Copyright © 2024 Elsevier B.V. All rights reserved.

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