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Rise in bystander CPR linked to fall in deaths

Denmark sees tripling of cardiac arrest survival as rate of CPR attempts doubles

Louise Prime

Wednesday, 02 October 2013

A doubling of the rate of attempts at cardiopulmonary resuscitation in Denmark was significantly associated with a tripling in the likelihood of surviving an out-of-hospital cardiac arrest, research has shown. This occurred despite the rate of defibrillation by bystanders remaining low, according to a study published today in JAMA.

Nationwide initiatives set out to combat the low rates of bystander CPR for out-of-hospital cardiac arrest (less than 20% of cases) and low 30-day survival (less than 6%) that were identified in Denmark 10 years ago. An increase in mandatory and voluntary first aid training meant that between 2008 and 2010 about 15% of the population were estimated to have done CPR courses.

Researchers set out to assess the effects of these initiatives by examining the past 10 years’ data on 19,468 men and women, median age 72 years, on whom resuscitation had been attempted after an out-of-hospital cardiac arrest.

There was a more than doubling in the rate of attempted CPR during the study period, from 21.1% in 2001 to 44.9% in 2010; the researchers said this was probably because of the increase in people having had CPR training. The rate of defibrillation by a bystander also doubled, but from a very low initial rate of 1.1% to just 2.2%.

At the same time, the likelihood of reaching hospital alive after an out-of-hospital cardiac arrest almost tripled from 7.9% to 21.8%, 30-day survival more than tripled from 3.5% to 10.8%, and one-year survival rose from 2.9% to 10.2%. Receiving CPR from a bystander was significantly associated with surviving at least 30 days after cardiac arrest.

The study’s authors said: “Our nationwide study had four major findings: rates of bystander CPR increased substantially; survival rates at 30 days and 1 year more than tripled; the number of survivors per 100,000 persons more than doubled; and rates of defibrillation by bystanders remained low.”

They concluded: “In Denmark between 2001 and 2010, an increase in survival following out-of-hospital cardiac arrest was significantly associated with a concomitant increase in bystander CPR,” but added “Because of the co-occurrence of other related initiatives, a causal relationship remains uncertain.”

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