The impact of dispatcher-assisted CPR and prior bystander CPR training on neurologic outcomes in out-of-hospital cardiac arrest: a multicenter study.

Abstract

The objective of this study was to evaluate the effectiveness of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) among laypersons, focusing on its impact on those with and without prior CPR training in out-of-hospital cardiac arrest (OHCA) cases. This prospective multicenter observational study included 42 emergency hospitals participating in the SOS-KANTO 2017 study (September 2019-March 2021). Patients with non-traumatic OHCA witnessed by laypersons were categorized into five groups: no bystander CPR, bystander non-DA-CPR without CPR training, bystander non-DA-CPR with CPR training, bystander DA-CPR without CPR training, and bystander DA-CPR with CPR training. The primary outcome was favorable neurological outcomes at one month. Among 2,772 patients analyzed, the proportions of favorable neurological outcomes were 3.0%, 7.4%, 7.4%, 15.7%, and 25.6% in the respective groups. In multivariable analyses, the highest odds of favorable neurological outcomes were observed in the non-DA-CPR with CPR training group (OR 9.0, 95% CI 2.8-29.6), followed by the DA-CPR with CPR training group (OR 3.1, 95% CI 1.1-8.5), DA-CPR without CPR training group (OR 2.5, 95% CI 1.3-4.9), and bystander non-DA-CPR without CPR training group (OR 1.6, 95% CI 0.8-3.2), with no bystander CPR as the reference. DA-CPR and prior CPR training play crucial roles in improving favorable neurological outcomes in bystander-witnessed OHCA cases. Additionally, DA-CPR may be particularly effective for untrained bystanders. These findings highlight the importance of integrating widespread CPR training programs and robust DA-CPR protocols into community-based emergency response systems.