Association between time taken to start dispatch assisted-bystander cardiopulmonary resuscitation (DA-CPR) and outcomes for out-of-hospital cardiac arrest (OHCA)

Abstract

Background: We aimed to investigate the association between the time taken to start dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) and survival outcomes for OHCA.

Methods: This was a retrospective analysis using the Singapore Pan-Asian Resuscitation Outcomes Study data between 2012 and 2021. We included all adult, witnessed, non-traumatic OHCA patients who received DA-CPR. The exposure of interest was time interval from emergency call to start of DA-CPR. Patients were divided into three groups based on previous studies. The outcome was defined as survival to 30-days with favorable neurological outcomes. Multivariable logistic regression analysis was performed. Restricted cubic spline curves were used to explore non-linear relationships.

Results: 3,861 OHCA patients were included in this analysis. Patients were grouped as follows: short (0-179 s), medium (180-239 s), and long (≥240 s) to start DA-CPR. Adjusted odds ratios [95% CI] for survival to 30-days with favorable neurological outcomes were: medium 0.82 [0.52-1.28], long 0.63 [0.40-0.98]. The restricted cubic spline curve showed a monotonic decrease in the odds ratio for survival to 30-days with favorable neurological outcomes.

Conclusions: This study found that among non-traumatic, witnessed OHCA patients who received DA-CPR, a shorter time to start DA-CPR was associated with better 30-day survival with favorable neurological outcomes.

Keywords: Bystander CPR; CPR training; Dispatcher-assisted cardiopulmonary resuscitation; Out-of-hospital cardiac arrest.