Chest compression-only bystander cardiopulmonary resuscitation (CPR) may be as effective
as conventional CPR with rescue breathing for out-of-hospital cardiac arrest.
To investigate the survival of patients with out-of-hospital cardiac arrest using
compression-only CPR (COCPR) compared with conventional CPR.
A 5-year prospective observational cohort study of survival in patients at least 18
years old with out-of-hospital cardiac arrest between January 1, 2005, and December
31, 2009, in Arizona. The relationship between layperson bystander CPR and survival
to hospital discharge was evaluated using multivariable logistic regression.
Survival to hospital discharge.
Among 5272 adults with out-of-hospital cardiac arrest of cardiac etiology not observed
by responding emergency medical personnel, 779 were excluded because bystander CPR
was provided by a health care professional or the arrest occurred in a medical facility.
A total of 4415 met all inclusion criteria for analysis, including 2900 who received
no bystander CPR, 666 who received conventional CPR, and 849 who received COCPR. Rates
of survival to hospital discharge were 5.2% (95% confidence interval [CI], 4.4%-6.0%)
for the no bystander CPR group, 7.8% (95% CI, 5.8%-9.8%) for conventional CPR, and
13.3% (95% CI, 11.0%-15.6%) for COCPR. The adjusted odds ratio (AOR) for survival
for conventional CPR vs no CPR was 0.99 (95% CI, 0.69-1.43), for COCPR vs no CPR,
1.59 (95% CI, 1.18-2.13), and for COCPR vs conventional CPR, 1.60 (95% CI, 1.08-2.35).
From 2005 to 2009, lay rescuer CPR increased from 28.2% (95% CI, 24.6%-31.8%) to 39.9%
(95% CI, 36.8%-42.9%; P < .001); the proportion of CPR that was COCPR increased from
19.6% (95% CI, 13.6%-25.7%) to 75.9% (95% CI, 71.7%-80.1%; P < .001). Overall survival
increased from 3.7% (95% CI, 2.2%-5.2%) to 9.8% (95% CI, 8.0%-11.6%; P < .001).
Among patients with out-of-hospital cardiac arrest, layperson compression-only CPR
was associated with increased survival compared with conventional CPR and no bystander
CPR in this setting with public endorsement of chest compression-only CPR.