International multi-center real world implementation trial to increase out-of-hospital cardiac arrest survival with a dispatcher-assisted cardio-pulmonary resuscitation package (Pan-Asian resuscitation outcomes study phase 2)

Marcus Eng Hock Ong, Sang Do Shin, Patrick Chow In Ko, Xinyi Lin, Matthew Huei Ming Ma, Hyun Wook Ryoo, Kwanhathai Darin Wong, Jirapong Supasaowapak, Chih Hao Lin, Chan Wei Kuo, Ramana Rao, Wenwei Cai, Faith Joan Gaerlan, Munawar Khursheed, Do Ngoc Son, Karim Sarah, Mazen El Sayed, Saad Al Qahtani, Hideharu Tanaka

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background: Dispatcher-assisted CPR (DA-CPR) has the potential to deliver early bystander CPR (BCPR) and improve out-of-hospital cardiac arrest (OHCA) survival. This study in the Asia-Pacific evaluated the impact of a DA-CPR program on BCPR rates and survival. Methods: This was a three-arm, prospective, multi-national, population-based, community-level, implementation trial. Cases between January 2009 and June 2018 from the Pan-Asian Resuscitation Outcomes Study were included. Sites either implemented a comprehensive (with quality improvement tool) or a basic DA-CPR package, or served as controls. Primary outcome was survival-to-discharge/30th day post-arrest. Secondary outcomes were BCPR and favorable neurological outcome. A before-after comparison was made within each country; this before-after change was then compared across the three groups using logistic regression. Results: 170,687 cases were analyzed. Before-after comparison showed that survival to discharge was higher in the ‘implementation’ period in all three groups: comprehensive odds ratio (OR) 1.09, 95% confidence interval (CI; [1.0–1.19]); basic OR 1.14, 95% CI (1.08–1.2); and control OR 1.25, 95% CI (1.02–1.53). Comparing between groups, the comprehensive group had significantly higher change in BCPR (comprehensive vs control ratio of OR 1.86, 95% CI [1.66–2.09]; basic vs control ratio of OR 0.94, 95% CI [0.85–1.05]; and comprehensive vs basic ratio of OR 1.97, 95% CI [1.87–2.08]) and survival with favorable neurological outcome (comprehensive vs basic ratio of OR 1.2, 95% CI [1.04–1.39]). Conclusion: We evaluated the impact of a DA-CPR program across heterogeneous EMS systems and demonstrated that a comprehensive DA-CPR program had the most impact on BCPR and favorable neurological outcome.

Original languageEnglish
Pages (from-to)80-89
Number of pages10
JournalResuscitation
Volume171
DOIs
Publication statusPublished - 2022 Feb

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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