Effectiveness of Bystander Cardiopulmonary Resuscitation and Survival Following Out-of-Hospital Cardiac Arrest

E. John Gallagher, Gary Lombardi, Paul Gennis

Research output: Contribution to journalArticle

388 Citations (Scopus)

Abstract

To examine the independent relationship between effectiveness of bystander cardiopulmonary resuscitation (CPR) and survival following out-of-hospital cardiac arrest. Prospective observational cohort. New York City. A total of 2071 consecutive out-of-hospital cardiac arrests meeting Utstein criteria. Trained prehospital personnel assessed the quality of bystander CPR on arrival at the scene. Satisfactory execution of CPR required performance of both adequate compressions and ventilations in conformity with current American Heart Association guidelines. Adjusted association between CPR effectiveness and survival. Survival was defined as discharge from hospital to home. Outcome was determined on all members of the inception cohort— none were lost to follow-up. When the association between bystander CPR and survival was adjusted for effectiveness of CPR in the parent data set (N=2071), only effective CPR was retained in the logistic model (adjusted odds ratio [OR]=5.7; 95% confidence interval [CI], 2.7 to 12.2; P<.001). Of the subset of 662 individuals (32%) who received bystander CPR, 305 (46%) had it performed effectively. Of these, 4.6% (14/305) survived vs 1.4% (5/357) of those with ineffective CPR (OR=3.4; 95% CI, 1.1 to 12.1; P<.02). After adjustment for witness status, initial rhythm, interval from collapse to CPR, and interval from collapse to advanced life support, effective CPR remained independently associated with improved survival (adjusted OR=3.9; 95% CI, 1.1 to 14.0; P<.04). The association between bystander CPR and survival in out-of-hospital cardiac arrest appears to be confounded by CPR quality. Effective CPR is independently associated with a quantitatively and statistically significant improvement in survival.

Original languageEnglish (US)
Pages (from-to)1922-1925
Number of pages4
JournalJAMA - Journal of the American Medical Association
Volume274
Issue number24
DOIs
StatePublished - Dec 27 1995

Fingerprint

Out-of-Hospital Cardiac Arrest
Cardiopulmonary Resuscitation
Odds Ratio
Confidence Intervals
Lost to Follow-Up

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effectiveness of Bystander Cardiopulmonary Resuscitation and Survival Following Out-of-Hospital Cardiac Arrest. / Gallagher, E. John; Lombardi, Gary; Gennis, Paul.

In: JAMA - Journal of the American Medical Association, Vol. 274, No. 24, 27.12.1995, p. 1922-1925.

Research output: Contribution to journalArticle

@article{c7c860b0138a4c2493a9fe974ead1ea4,
title = "Effectiveness of Bystander Cardiopulmonary Resuscitation and Survival Following Out-of-Hospital Cardiac Arrest",
abstract = "To examine the independent relationship between effectiveness of bystander cardiopulmonary resuscitation (CPR) and survival following out-of-hospital cardiac arrest. Prospective observational cohort. New York City. A total of 2071 consecutive out-of-hospital cardiac arrests meeting Utstein criteria. Trained prehospital personnel assessed the quality of bystander CPR on arrival at the scene. Satisfactory execution of CPR required performance of both adequate compressions and ventilations in conformity with current American Heart Association guidelines. Adjusted association between CPR effectiveness and survival. Survival was defined as discharge from hospital to home. Outcome was determined on all members of the inception cohort— none were lost to follow-up. When the association between bystander CPR and survival was adjusted for effectiveness of CPR in the parent data set (N=2071), only effective CPR was retained in the logistic model (adjusted odds ratio [OR]=5.7; 95{\%} confidence interval [CI], 2.7 to 12.2; P<.001). Of the subset of 662 individuals (32{\%}) who received bystander CPR, 305 (46{\%}) had it performed effectively. Of these, 4.6{\%} (14/305) survived vs 1.4{\%} (5/357) of those with ineffective CPR (OR=3.4; 95{\%} CI, 1.1 to 12.1; P<.02). After adjustment for witness status, initial rhythm, interval from collapse to CPR, and interval from collapse to advanced life support, effective CPR remained independently associated with improved survival (adjusted OR=3.9; 95{\%} CI, 1.1 to 14.0; P<.04). The association between bystander CPR and survival in out-of-hospital cardiac arrest appears to be confounded by CPR quality. Effective CPR is independently associated with a quantitatively and statistically significant improvement in survival.",
author = "Gallagher, {E. John} and Gary Lombardi and Paul Gennis",
year = "1995",
month = "12",
day = "27",
doi = "10.1001/jama.1995.03530240032036",
language = "English (US)",
volume = "274",
pages = "1922--1925",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "24",

}

TY - JOUR

T1 - Effectiveness of Bystander Cardiopulmonary Resuscitation and Survival Following Out-of-Hospital Cardiac Arrest

AU - Gallagher, E. John

AU - Lombardi, Gary

AU - Gennis, Paul

PY - 1995/12/27

Y1 - 1995/12/27

N2 - To examine the independent relationship between effectiveness of bystander cardiopulmonary resuscitation (CPR) and survival following out-of-hospital cardiac arrest. Prospective observational cohort. New York City. A total of 2071 consecutive out-of-hospital cardiac arrests meeting Utstein criteria. Trained prehospital personnel assessed the quality of bystander CPR on arrival at the scene. Satisfactory execution of CPR required performance of both adequate compressions and ventilations in conformity with current American Heart Association guidelines. Adjusted association between CPR effectiveness and survival. Survival was defined as discharge from hospital to home. Outcome was determined on all members of the inception cohort— none were lost to follow-up. When the association between bystander CPR and survival was adjusted for effectiveness of CPR in the parent data set (N=2071), only effective CPR was retained in the logistic model (adjusted odds ratio [OR]=5.7; 95% confidence interval [CI], 2.7 to 12.2; P<.001). Of the subset of 662 individuals (32%) who received bystander CPR, 305 (46%) had it performed effectively. Of these, 4.6% (14/305) survived vs 1.4% (5/357) of those with ineffective CPR (OR=3.4; 95% CI, 1.1 to 12.1; P<.02). After adjustment for witness status, initial rhythm, interval from collapse to CPR, and interval from collapse to advanced life support, effective CPR remained independently associated with improved survival (adjusted OR=3.9; 95% CI, 1.1 to 14.0; P<.04). The association between bystander CPR and survival in out-of-hospital cardiac arrest appears to be confounded by CPR quality. Effective CPR is independently associated with a quantitatively and statistically significant improvement in survival.

AB - To examine the independent relationship between effectiveness of bystander cardiopulmonary resuscitation (CPR) and survival following out-of-hospital cardiac arrest. Prospective observational cohort. New York City. A total of 2071 consecutive out-of-hospital cardiac arrests meeting Utstein criteria. Trained prehospital personnel assessed the quality of bystander CPR on arrival at the scene. Satisfactory execution of CPR required performance of both adequate compressions and ventilations in conformity with current American Heart Association guidelines. Adjusted association between CPR effectiveness and survival. Survival was defined as discharge from hospital to home. Outcome was determined on all members of the inception cohort— none were lost to follow-up. When the association between bystander CPR and survival was adjusted for effectiveness of CPR in the parent data set (N=2071), only effective CPR was retained in the logistic model (adjusted odds ratio [OR]=5.7; 95% confidence interval [CI], 2.7 to 12.2; P<.001). Of the subset of 662 individuals (32%) who received bystander CPR, 305 (46%) had it performed effectively. Of these, 4.6% (14/305) survived vs 1.4% (5/357) of those with ineffective CPR (OR=3.4; 95% CI, 1.1 to 12.1; P<.02). After adjustment for witness status, initial rhythm, interval from collapse to CPR, and interval from collapse to advanced life support, effective CPR remained independently associated with improved survival (adjusted OR=3.9; 95% CI, 1.1 to 14.0; P<.04). The association between bystander CPR and survival in out-of-hospital cardiac arrest appears to be confounded by CPR quality. Effective CPR is independently associated with a quantitatively and statistically significant improvement in survival.

UR - http://www.scopus.com/inward/record.url?scp=0029589881&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029589881&partnerID=8YFLogxK

U2 - 10.1001/jama.1995.03530240032036

DO - 10.1001/jama.1995.03530240032036

M3 - Article

C2 - 8568985

AN - SCOPUS:0029589881

VL - 274

SP - 1922

EP - 1925

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 24

ER -