Critical Care and Shock

Dispatcher-assisted cardiopulmonary resuscitation improves the neurological outcomes of out-of-hospital cardiac arrest victims: a retrospective analysis of prehospitalisation records in Kumamoto City

Abstract

Background: Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is an effective tool for improving the outcome of out-of-hospital cardiac arrest (OHCA) by providing dispatcher assistance (DA) to bystander cardiopulmonary resuscitation (BCPR) and public access defibrillators (PAD). However, it is unclear whether DA-CPR improves the neurological outcomes of OHCA. In this study, we assessed the effectiveness of DA-CPR using prehospitalisation records in Kumamoto City (Japan), which has a population of 730,000, an area of 390 km2, and 25 ambulances. The DA-CPR protocol in Kumamoto City commenced in 2014.

Methods: We retrospectively analysed the prehospitalisation records in Kumamoto City between 2014 and 2016. The cases were divided into two groups according to whether they received DA: DA group and non-DA group. The BCPR and PAD rates were compared between the two groups. The neurological outcomes (Glasgow–Pittsburgh cerebral performance category 1–2) were compared between the two groups by propensity score analysis with inverse probability of treatment weighting.

Results: A total of 1607 prehospitalisation records were identified and divided into the DA (n=1132) and non-DA (n=474) groups. BCPR (72% vs 17%, p<0.001) and PAD (11% vs 5%, p<0.001) rates were greater in the DA group. Propensity score analysis showed that the neurological outcome was significantly better in the DA group (odds ratio 1.718; 95% confidence interval: 1.017-2.902; p=0.0431).

Conclusions: DA-CPR was associated with improved BCPR, PAD, and neurological outcomes of OHCA in this analysis of prehospitalisation cases in Kumamoto City.