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. 2024 Nov 29;14(1):29671.
doi: 10.1038/s41598-024-81263-8.

The impact of smartphone-dispatched CPR-trained volunteers on OHCA outcomes is influenced by patient age

Johanna Fabianek  1   2 , Marc Felzen  1   2   3 , Kim R Riester  1   2 , Stefan K Beckers  1   2   3 , Rolf Rossaint  1 , Hanna Schröder  1   2   3 , Mark Pitsch  4   5
Affiliations

The impact of smartphone-dispatched CPR-trained volunteers on OHCA outcomes is influenced by patient age

Johanna Fabianek et al. Sci Rep. .

Abstract

The early initiation of cardiopulmonary resuscitation (CPR) measures by non-professionals before the arrival of Emergency Medical Service (EMS) is known to be crucial for improving outcomes after out-of-hospital cardiac arrest (OHCA). We assessed the impact of deploying CPR-trained volunteers via a smartphone-based alerting system on the outcome of OHCA patients. In a retrospective nonrandomized cohort study, all OHCA cases in the city of Aachen over a six-year period were analysed. We compared patient data, CPR metrics, alerting system data as well as outcome data between the intervention and control groups. From June 2017 to May 2023, 101 out of 852 resuscitations were initiated by volunteers alerted via a smartphone-based alerting system in OHCA events. We found no overall rise in the return of spontaneous circulation (ROSC) rate. An age-dependent subgroup analysis indicated an increased incidence of initially shockable rhythms and an increased ROSC rate for patients younger than 60 years in the intervention group, while implying a lower ROSC rate in patients older than 80 years after mobile responder CPR. Although this study was underpowered to yield statistically significant results, our findings suggest the need for an age-sensitive approach when evaluating the effects of first-responder systems on OHCA cases.

Keywords: First responder system; Mobile-phone; Out-of-hospital cardiac arrest; Resuscitation; Resuscitation-free interval; Smartphone-based alerting system.

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Conflict of interest statement

Data availability: The datasets analyzed in the current study are not publicly available because they are municipal property and cannot be published online under open-access agreements. However, these datasets are available upon reasonable request and with permission from municipal authorities. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Screen of the “Corhelper” application showing the map of the city center of Aachen with available AEDs (left) and simulated “Corhelper” operation with directions to the patient (right).
Fig. 2
Fig. 2
Mobile responder inclusion flowchart. EMS = emergency medical service; OHCA = Out-of-hospital cardiac arrest.
Fig. 3
Fig. 3
Comparison between mobile responder-initiated resuscitations and EMS-initiated resuscitations regarding outcome parameters in different age groups. (A) ROSC-rate, (B) Initial shockable rhythm, (C) Proportion of bystander-witnessed OHCA, (D) Proportion of hospital admission with ongoing CPR. EMS = emergency medical service; OHCA = Out-of-hospital cardiac arrest; CPR = cardiopulmonary resuscitation.
Fig. 4
Fig. 4
Proportion and absolute numbers of mobile responder alerts among all OHCAs in 2017 and 2023. OHCA = Out-of-hospital cardiac arrest.
See this image and copyright information in PMC

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