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Association between type of bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest: A machine learning study

AIM: In the event of an out of hospital cardiac arrest (OHCA) it is recommended for a sole untrained bystander to perform compression only CPR (CO-CPR). However, it remains unknown if CO-CPR is inferior to standard CPR (S-CPR), including both compressions and ventilation, in terms of survival. One c...

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Autores principales: Jerkeman, Matilda, Lundgren, Peter, Omerovic, Elmir, Strömsöe, Anneli, Riva, Gabriel, Hollenberg, Jacob, Nivedahl, Per, Herlitz, Johan, Rawshani, Araz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207566/
https://www.ncbi.nlm.nih.gov/pubmed/35734307
http://dx.doi.org/10.1016/j.resplu.2022.100245
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author Jerkeman, Matilda
Lundgren, Peter
Omerovic, Elmir
Strömsöe, Anneli
Riva, Gabriel
Hollenberg, Jacob
Nivedahl, Per
Herlitz, Johan
Rawshani, Araz
author_facet Jerkeman, Matilda
Lundgren, Peter
Omerovic, Elmir
Strömsöe, Anneli
Riva, Gabriel
Hollenberg, Jacob
Nivedahl, Per
Herlitz, Johan
Rawshani, Araz
author_sort Jerkeman, Matilda
collection PubMed
description AIM: In the event of an out of hospital cardiac arrest (OHCA) it is recommended for a sole untrained bystander to perform compression only CPR (CO-CPR). However, it remains unknown if CO-CPR is inferior to standard CPR (S-CPR), including both compressions and ventilation, in terms of survival. One could speculate that due to the current pandemic, bystanders may be more hesitant performing mouth-to-mouth ventilation. The aim of this study is to assess the association between type of bystander CPR and survival in OHCA. METHODS: This study included all patients with a bystander treated OHCA between year 2015–2019 in ages 18–100 using The Swedish Registry for Cardiopulmonary Resuscitation (SRCR). We compared CO-CPR to S-CPR in terms of 30-day survival using a propensity score approach based on machine learning adjusting for a large number of covariates. RESULTS: A total of 13,481 patients were included (5,293 with S-CPR and 8,188 with CO-CPR). The matched subgroup consisted of 2994 cases in each group. Gradient boosting were the best models with regards to predictive accuracy (for type of bystander CPR) and covariate balance. The difference between S-CPR and CO-CPR in all 30 models computed on covariate adjustment and 1-to-1 matching were non-significant. In the 30 weighted models, three comparisons (S-CPR vs. CO-CPR) were significant in terms of improved survival; odds ratio for men was 1.21 (99% confidence interval (CI) 1.02–1.43; Average treatment effect (ATE)); for patients ≥73 years 1.57 (99% CI 1.17–2.12) for Average treatment effect on treated (ATT) and 1.63 (99% CI 1.18–2.25) for ATE. Remaining 27 models showed no differences. No significances remain after adjustment for multiple testing. CONCLUSION: We found no significant differences between S-CPR and CO-CPR in terms of survival, supporting current recommendations for untrained bystanders regarding CO-CPR.
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spelling pubmed-92075662022-06-21 Association between type of bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest: A machine learning study Jerkeman, Matilda Lundgren, Peter Omerovic, Elmir Strömsöe, Anneli Riva, Gabriel Hollenberg, Jacob Nivedahl, Per Herlitz, Johan Rawshani, Araz Resusc Plus Clinical Paper AIM: In the event of an out of hospital cardiac arrest (OHCA) it is recommended for a sole untrained bystander to perform compression only CPR (CO-CPR). However, it remains unknown if CO-CPR is inferior to standard CPR (S-CPR), including both compressions and ventilation, in terms of survival. One could speculate that due to the current pandemic, bystanders may be more hesitant performing mouth-to-mouth ventilation. The aim of this study is to assess the association between type of bystander CPR and survival in OHCA. METHODS: This study included all patients with a bystander treated OHCA between year 2015–2019 in ages 18–100 using The Swedish Registry for Cardiopulmonary Resuscitation (SRCR). We compared CO-CPR to S-CPR in terms of 30-day survival using a propensity score approach based on machine learning adjusting for a large number of covariates. RESULTS: A total of 13,481 patients were included (5,293 with S-CPR and 8,188 with CO-CPR). The matched subgroup consisted of 2994 cases in each group. Gradient boosting were the best models with regards to predictive accuracy (for type of bystander CPR) and covariate balance. The difference between S-CPR and CO-CPR in all 30 models computed on covariate adjustment and 1-to-1 matching were non-significant. In the 30 weighted models, three comparisons (S-CPR vs. CO-CPR) were significant in terms of improved survival; odds ratio for men was 1.21 (99% confidence interval (CI) 1.02–1.43; Average treatment effect (ATE)); for patients ≥73 years 1.57 (99% CI 1.17–2.12) for Average treatment effect on treated (ATT) and 1.63 (99% CI 1.18–2.25) for ATE. Remaining 27 models showed no differences. No significances remain after adjustment for multiple testing. CONCLUSION: We found no significant differences between S-CPR and CO-CPR in terms of survival, supporting current recommendations for untrained bystanders regarding CO-CPR. Elsevier 2022-06-14 /pmc/articles/PMC9207566/ /pubmed/35734307 http://dx.doi.org/10.1016/j.resplu.2022.100245 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Clinical Paper
Jerkeman, Matilda
Lundgren, Peter
Omerovic, Elmir
Strömsöe, Anneli
Riva, Gabriel
Hollenberg, Jacob
Nivedahl, Per
Herlitz, Johan
Rawshani, Araz
Association between type of bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest: A machine learning study
title Association between type of bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest: A machine learning study
title_full Association between type of bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest: A machine learning study
title_fullStr Association between type of bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest: A machine learning study
title_full_unstemmed Association between type of bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest: A machine learning study
title_short Association between type of bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest: A machine learning study
title_sort association between type of bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest: a machine learning study
topic Clinical Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207566/
https://www.ncbi.nlm.nih.gov/pubmed/35734307
http://dx.doi.org/10.1016/j.resplu.2022.100245
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