• Resuscitation · Feb 2019

    Cardiopulmonary resuscitation performed by off-duty medical professionals versus laypersons and survival from out-of-hospital cardiac arrest among adult patients.

    • Daisuke Kobayashi, Tetsuhisa Kitamura, Kosuke Kiyohara, Chika Nishiyama, Sumito Hayashida, Tasuku Matsuyama, Yusuke Katayama, Tomonari Shimamoto, Takeyuki Kiguchi, Satoe Okabayashi, Takashi Kawamura, and Taku Iwami.
    • Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto, 606-8501, Japan.
    • Resuscitation. 2019 Feb 1; 135: 66-72.

    BackgroundCardiopulmonary resuscitation (CPR) performed by bystanders is a key factor for out-of-hospital cardiac arrest (OHCA) survival. This study aimed to evaluate the relationship between CPR performed by off-duty medical professionals vs. laypersons and one-month survival with favorable neurological outcome after OHCA.MethodsUsing a population-based database of OHCA patients in Osaka City, Japan, from 2013 through 2015, we enrolled adult OHCA patients with resuscitation attempts performed by bystanders before the arrival of emergency-medical-service personnel. Multivariable logistic regression analysis was performed to assess the association between CPR performed by off-duty medical professionals vs. laypersons and the OHCA outcome after adjusting for potential confounding factors. The primary outcome measure was one-month survival with favorable neurological outcome, defined as cerebral performance category of 1 or 2.ResultsA total of 2326 subjects were eligible for our study. Among these, 365 (15.7%) patients received CPR by off-duty medical professionals and 1,961 (84.3%) received CPR by laypersons. In the multivariable analysis, there was no difference in favorable neurological outcome between off-duty medical professionals (6.3% [23/365]) and laypersons (5.1% [100/1,961]) among eligible patients (adjusted odds ratio 0.83, 95% confidence interval [0.37-2.06]). This finding was also confirmed in propensity score-matched patients.ConclusionsIn Japan where the CPR training or bystander CPR has been widely disseminating, CPR by laypersons had similar effects compared to that by off-duty medical professionals. As this study could not assess the quality of bystander CPR, further studies are essential to verify the effects of the bystander CPR type on OHCA patients.Copyright © 2019 Elsevier B.V. All rights reserved.

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