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Meta-Analysis
. 2020 Feb 22;24(1):61.
doi: 10.1186/s13054-020-2773-2.

The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis

Shijiao Yan  1   2 , Yong Gan  3 , Nan Jiang  3 , Rixing Wang  4 , Yunqiang Chen  2   5 , Zhiqian Luo  2   5 , Qiao Zong  6 , Song Chen  7 , Chuanzhu Lv  8   9   10
Affiliations
Meta-Analysis

The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis

Shijiao Yan et al. Crit Care. .

Abstract

Background: To quantitatively summarize the available epidemiological evidence on the survival rate of out-of-hospital cardiac arrest (OHCA) patients who received cardiopulmonary resuscitation (CPR).

Methods: We systematically searched the PubMed, Embase, and Web of Science databases, and the references of retrieved articles were manually reviewed to identify studies reporting the outcome of OHCA patients who received CPR. The overall incidence and outcome of OHCA were assessed using a random-effects meta-analysis.

Results: A total of 141 eligible studies were included in this meta-analysis. The pooled incidence of return of spontaneous circulation (ROSC) was 29.7% (95% CI 27.6-31.7%), the rate of survival to hospital admission was 22.0% (95% CI 20.7-23.4%), the rate of survival to hospital discharge was 8.8% (95% CI 8.2-9.4%), the pooled 1-month survival rate was 10.7% (95% CI 9.1-13.3%), and the 1-year survival rate was 7.7% (95% CI 5.8-9.5%). Subgroup analysis showed that survival to hospital discharge was more likely among OHCA patients whose cardiac arrest was witnessed by a bystander or emergency medical services (EMS) (10.5%; 95% CI 9.2-11.7%), who received bystander CPR (11.3%, 95% CI 9.3-13.2%), and who were living in Europe and North America (Europe 11.7%; 95% CI 10.5-13.0%; North America: 7.7%; 95% CI 6.9-8.6%). The survival to discharge (8.6% in 1976-1999 vs. 9.9% in 2010-2019), 1-month survival (8.0% in 2000-2009 vs. 13.3% in 2010-2019), and 1-year survival (8.0% in 2000-2009 vs. 13.3% in 2010-2019) rates of OHCA patients who underwent CPR significantly increased throughout the study period. The Egger's test did not indicate evidence of publication bias for the outcomes of OHCA patients who underwent CPR.

Conclusions: The global survival rate of OHCA patients who received CPR has increased in the past 40 years. A higher survival rate post-OHCA is more likely among patients who receive bystander CPR and who live in Western countries.

Keywords: Emergency medical services; Out-of-hospital cardiac arrest; Resuscitation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of relevant study identification in relation to outcomes of OHCA who underwent CPR
Fig. 2
Fig. 2
Funnel plot for the incidence of ROSC among OHCA patients who underwent CPR
Fig. 3
Fig. 3
Funnel plot for the incidence of survival to admission among OHCA patients who underwent CPR
Fig. 4
Fig. 4
Funnel plot for the incidence of survival to discharge among OHCA patients who underwent CPR
Fig. 5
Fig. 5
Funnel plot for the 1 month survival rate among OHCA patients who underwent CPR
Fig. 6
Fig. 6
Funnel plot for the 1 year survival rate among OHCA patients who underwent CPR
See this image and copyright information in PMC

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