Document Detail


Outcomes of chest compression only CPR versus conventional CPR conducted by lay people in patients with out of hospital cardiopulmonary arrest witnessed by bystanders: nationwide population based observational study.
MedLine Citation:
PMID:  21273279     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the effectiveness of cardiopulmonary resuscitation (CPR) with chest compression only and conventional CPR on outcomes after cardiopulmonary arrest out of hospital.
DESIGN: Nationwide population based observational study.
SETTING: A nationwide emergency medical service system in Japan. Population All consecutive patients with out of hospital cardiopulmonary arrest, January 2005 to December 2007 in Japan, witnessed at the moment of collapse. Lay people attempted chest compression only CPR (n = 20,707) or conventional CPR (mouth to mouth ventilation and chest compression) (n = 19,328), and patients were transferred to hospital by ambulance.
MAIN OUTCOME MEASURES: Factors associated with better outcomes (assessed with χ(2), multiple logistic regression analysis, odds ratios and their 95% confidence intervals): one month survival and neurologically favourable one month survival rates defined as category one (good cerebral performance) or two (moderate cerebral disability) of the cerebral performance categories.
RESULTS: Conventional CPR was associated with better outcomes than chest compression only CPR, for both one month survival (adjusted odds ratio 1.17, 95% confidence interval 1.06 to 1.29) and neurologically favourable one month survival (1.17, 1.01 to 1.35). Neurologically favourable one month survival decreased with increasing age and with delays of up to 10 minutes in starting CPR for both conventional and chest compression only CPR. The benefit of conventional CPR over chest compression only CPR was significantly greater in younger people in non-cardiac cases (P = 0.025) and with a delay in start of CPR after the event was witnessed in non-cardiac cases (P = 0.015) and all cases combined (P = 0.037).
CONCLUSIONS: Conventional CPR is associated with better outcomes than chest compression only CPR for selected patients with out of hospital cardiopulmonary arrest, such as those with arrests of non-cardiac origin and younger people, and people in whom there was delay in the start of CPR.
Authors:
Toshio Ogawa; Manabu Akahane; Soichi Koike; Seizan Tanabe; Tatsuhiro Mizoguchi; Tomoaki Imamura
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Publication Detail:
Type:  Journal Article     Date:  2011-01-27
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  342     ISSN:  1756-1833     ISO Abbreviation:  BMJ     Publication Date:  2011  
Date Detail:
Created Date:  2011-01-28     Completed Date:  2011-03-01     Revised Date:  2012-03-06    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  England    
Other Details:
Languages:  eng     Pagination:  c7106     Citation Subset:  AIM; IM    
Affiliation:
Nara Medical University School of Medicine, Department of Public Health, Health Management and Policy, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan. ogawat@naramed-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation / methods*,  mortality
Emergency Medical Services / methods*
Female
Heart Arrest / mortality,  therapy*
Heart Massage / methods*
Humans
Japan
Male
Middle Aged
Treatment Outcome
Voluntary Workers
Young Adult
Comments/Corrections
Comment In:
BMJ. 2011;342:d374   [PMID:  21273280 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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