Estimating the effect of bystander-initiated cardiopulmonary resuscitationin Japan

Low incidence of bystander-initiated cardiopulmonary resuscitation (CPR) is allegedly responsible for poor survival from out-of-hospital cardiac arres t (OHCA) in Japan. This study was conducted to determine significant predic tors for survival after collapse-witnessed OHCA of presumed cardiac etiolog y to investigate the impact of bystander-initiated CPR. Logistic regression analysis of OHCA of presumed cardiac etiology was performed on retrospecti ve data sets from three Japanese suburban communities. All arrest incidents were witnessed and occurred prior to the arrival of EMS personnel. Outcome measure was survival to discharge. Initial electrocardiogram (ECG) rhythm (ventricular fibrillation (VF) or not), interval from collapse to CPR (with in 5 min or not), and initial ECG rhythm/collapse-to-CPR interval interacti on were significantly associated with survival. Patient age (70 years or le ss/over 70 years), interval from collapse to EMS response, and bystander-in itiated CPR were significantly associated with VF in an initial ECG. The ef fectiveness of bystander-initiated CPR for OHCA can be successfully predict ed based on the interval from collapse to CPR and initial ECG rhythm. The i ncrease in the proportion of bystander-initiated CPR from the present level of 20-50% would be expected to rescue another 1800 victims of OHCA per yea r in Japan, (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.