Abstract
Objectives: We analyzed the impact of the resuscitation guideline changes on the outcome of out-of-hospital cardiac arrest of cardiac origin witnessed by bystander. Methods: We reviewed 5,018 cases of bystander-witnessed cardiac arrest of cardiac origin that occurred in the Osaka prefecture between January 2005 and December 2008. We categorized these 5018 cases into 2 groups (group G2000: 2,185 cases and group G2005: 2,833 cases) on the basis of whether cardiac arrest occurred before or after changes were introduced in the guidelines and analyzed the outcomes. Results: The use of life-support measures, including intubation and drug administration by paramedics and public access defibrillation, was significantly higher in G2005 than in the G2000 group. The time interval between the emergency call and first defibrillation attempted by the paramedics was significantly longer in G2005 than in G2000. Also, the rate of restoration of spontaneous circulation, 1-month survival, and 1-month neurologically favorable survival was significantly higher in G2005 than in G2000. On the basis of the multivariate analysis, we found that G2005 demonstrated high 1-month neurologically favorable survival. Conclusions: The results suggest that the changes to the resuscitation guidelines have resulted in improved outcomes of out-of-hospital cardiac arrest of cardiac origin witnessed by bystander. Similar studies should be conducted in other areas to confirm the findings of our study.
