Changes in out-of-hospital cardiac arrest survival rates among patients with and without bystander intervention in the Cardiac Arrest Registry to Enhance Survival (CARES) program from 2010 to 2012 Open Access

Coutts, Katelyn Ann (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/j3860722w?locale=en
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Abstract

Background: Out-of-hospital cardiac arrest (OHCA) is a leading cause of death among adults in the U.S. While many factors influence the outcome for a patient experiencing OHCA (e.g., age, sex, and arrest location), bystander intervention is one that has potential for improvement, thus providing an opportunity to increase survival.

Objective: This analysis aimed to assess the changes in survival rates over time and to examine if the increase in survival was greater among the patients who received bystander intervention than among patients who did not receive bystander intervention.

Methods: Sites voluntarily participating in the Cardiac Arrest Registry to Enhance Survival (CARES) program for the entirety of January 1, 2010 to December 31, 2012 that reported at least five cardiac arrest events during that time were included in the study population (n=61 sites). All patients who experienced a witnessed OHCA event of confirmed cardiac etiology that occurred prior to EMS arrival and were found in an initial shockable cardiac rhythm were considered for inclusion (n=4,751). Multivariate logistic regression was performed to identify whether changes in the survival rate between 2010 and 2012 differed between those who received bystander intervention and those who did not.

Results: After controlling for patient age, sex, race/ethnicity, and event location (public or private), a 26% increase in survival when comparing 2010 to 2012 was observed among the patients who received bystander intervention (OR 1.26; 95% CI 1.01, 1.57). This trend in survival rate was not found among patients who did not receive bystander intervention (OR 0.89; 95% CI 0.71, 1.12).

Conclusion: These results suggest an improvement in bystander intervention among the participating agencies. Future survey and investigation of the 61 participating agencies will attempt to identify interventions and improvements that occurred during this timeframe that may have contributed to this change. This provides an opportunity to influence OHCA care and increase survival rates nationwide.

Table of Contents

Chapter I: Background................................................1

Chapter II: Manuscript.................................................9

Abstract....................................................................9

Introduction.............................................................10

Methods..................................................................13

Results....................................................................15

Discussion...............................................................18

Figures ...................................................................21

Tables ....................................................................22

References...............................................................29

Chapter III: Summary and Implications........................31

Summary.................................................................31

Future Directions and Public Health Implications............31

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