Faculty Collaboration Database

Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation. Circulation 2009 Sep 29;120(13):1241-7

Date

09/16/2009

Pubmed ID

19752324

Pubmed Central ID

PMC2795631

DOI

10.1161/CIRCULATIONAHA.109.852202

Scopus ID

2-s2.0-70349673319 (requires institutional sign-in at Scopus site)   629 Citations

Abstract

BACKGROUND: Quality cardiopulmonary resuscitation contributes to cardiac arrest survival. The proportion of time in which chest compressions are performed in each minute of cardiopulmonary resuscitation is an important modifiable aspect of quality cardiopulmonary resuscitation. We sought to estimate the effect of an increasing proportion of time spent performing chest compressions during cardiac arrest on survival to hospital discharge in patients with out-of-hospital ventricular fibrillation or pulseless ventricular tachycardia.

METHODS AND RESULTS: This is a prospective observational cohort study of adult patients from the Resuscitation Outcomes Consortium Cardiac Arrest Epistry with confirmed ventricular fibrillation or ventricular tachycardia, no defibrillation before emergency medical services arrival, electronically recorded cardiopulmonary resuscitation before the first shock, and a confirmed outcome. Patients were followed up to discharge from the hospital or death. Of the 506 cases, the mean age was 64 years, 80% were male, 71% were witnessed by a bystander, 51% received bystander cardiopulmonary resuscitation, 34% occurred in a public location, and 23% survived. After adjustment for age, gender, location, bystander cardiopulmonary resuscitation, bystander witness status, and response time, the odds ratios of surviving to hospital discharge in the 2 highest categories of chest compression fraction compared with the reference category were 3.01 (95% confidence interval 1.37 to 6.58) and 2.33 (95% confidence interval 0.96 to 5.63). The estimated adjusted linear effect on odds ratio of survival for a 10% change in chest compression fraction was 1.11 (95% confidence interval 1.01 to 1.21).

CONCLUSIONS: An increased chest compression fraction is independently predictive of better survival in patients who experience a prehospital ventricular fibrillation/tachycardia cardiac arrest.

Author List

Christenson J, Andrusiek D, Everson-Stewart S, Kudenchuk P, Hostler D, Powell J, Callaway CW, Bishop D, Vaillancourt C, Davis D, Aufderheide TP, Idris A, Stouffer JA, Stiell I, Berg R, Resuscitation Outcomes Consortium Investigators

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Cardiopulmonary Resuscitation
Cohort Studies
Databases, Factual
Electric Countershock
Emergency Medical Services
Female
Heart Arrest
Humans
Male
Middle Aged
Predictive Value of Tests
Tachycardia, Ventricular
Ventricular Fibrillation