J Korean Med Sci.  2018 Dec;33(51):e328. 10.3346/jkms.2018.33.e328.

Effect of National Implementation of Telephone CPR Program to Improve Outcomes from Out-of-Hospital Cardiac Arrest: an Interrupted Time-Series Analysis

• Lee YJ
• Hwang SS
• Shin SD
• Lee SC
• Song KJ

• KMID: 2428636
• DOI: http://doi.org/10.3346/jkms.2018.33.e328

Abstract

BACKGROUND
In cardiac arrest, the survival rate increases with the provision of bystander cardiopulmonary resuscitation (CPR), of which the initial response and treatment are critical. Telephone CPR is among the effective methods that might increase the provision of bystander CPR. This study aimed to describe and examine the improvement of neurological outcomes in individuals with out-of-hospital acute cardiac arrest by implementing the nationwide, standardized telephone CPR program.
METHODS
Data from the emergency medical service-based cardiac arrest registry that were collected between 2009 and 2014 were used. The effectiveness of the intervention in the interrupted time-series study was determined via a segmented regression analysis, which showed the risk ratio and risk difference in good neurological outcomes before and after the intervention.
RESULTS
Of 164,221 patients, 148,403 were analyzed. However, patients with unknown sex and limited data on treatment outcomes were excluded. Approximately 64.3% patients were men, with an average age of 63.7 years. The number of bystander CPR increased by 3.3 times (95% confidence interval [CI], 3.1-3.5) after the intervention, whereas the rate of good neurological outcomes increased by 2.6 times (95% CI, 2.3-2.9 [1.6%]; 1.4-1.7). The excess number was identified based on the differences between the observed and predicted trends. In total, 2,127 cases of out-of-hospital cardiac arrest (OHCA) after the intervention period received additional bystander CPR, and 339 cases of OHCA had good neurological outcomes.
CONCLUSION
The nationwide implementation of the standardized telephone CPR program increased the number of bystander CPR and improved good neurological outcomes.

Keyword

Cardiac Arrest; Telephone Cardiopulmonary Resuscitation; Outcomes

MeSH Terms

Cardiopulmonary Resuscitation*
Emergencies
Heart Arrest
Humans
Male
Odds Ratio
Out-of-Hospital Cardiac Arrest*
Survival Rate
Telephone*