Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation

Jim Christenson, Douglas Andrusiek, Siobhan Everson-Stewart, Peter Kudenchuk, David Hostler, Judy Powell, Clifton W. Callaway, Dan Bishop, Christian Vaillancourt, Dan Davis, Tom P. Aufderheide, Ahamed Idris, John A. Stouffer, Ian Stiell, Robert Berg

Research output: Contribution to journalArticle

450 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1241-1247
Number of pages7
JournalCirculation
Volume120
Issue number13
DOIs
StatePublished - Sep 2009

Fingerprint

Cardiopulmonary Resuscitation
Ventricular Fibrillation
Thorax
Heart Arrest
Survival
Ventricular Tachycardia
Confidence Intervals
Odds Ratio
Patient Discharge
Emergency Medical Services
Resuscitation
Reaction Time
Observational Studies
Shock
Cohort Studies

Keywords

  • Cardiopulmonary resuscitation
  • Fibrillation
  • Heart arrest
  • Survival

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Christenson, J., Andrusiek, D., Everson-Stewart, S., Kudenchuk, P., Hostler, D., Powell, J., ... Berg, R. (2009). Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation. Circulation, 120(13), 1241-1247. https://doi.org/10.1161/CIRCULATIONAHA.109.852202

Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation. / Christenson, Jim; Andrusiek, Douglas; Everson-Stewart, Siobhan; Kudenchuk, Peter; Hostler, David; Powell, Judy; Callaway, Clifton W.; Bishop, Dan; Vaillancourt, Christian; Davis, Dan; Aufderheide, Tom P.; Idris, Ahamed; Stouffer, John A.; Stiell, Ian; Berg, Robert.

In: Circulation, Vol. 120, No. 13, 09.2009, p. 1241-1247.

Research output: Contribution to journalArticle

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 2009, 'Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation', Circulation, vol. 120, no. 13, pp. 1241-1247. https://doi.org/10.1161/CIRCULATIONAHA.109.852202
Christenson J, Andrusiek D, Everson-Stewart S, Kudenchuk P, Hostler D, Powell J et al. Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation. Circulation. 2009 Sep;120(13):1241-1247. https://doi.org/10.1161/CIRCULATIONAHA.109.852202
Christenson, Jim ; Andrusiek, Douglas ; Everson-Stewart, Siobhan ; Kudenchuk, Peter ; Hostler, David ; Powell, Judy ; Callaway, Clifton W. ; Bishop, Dan ; Vaillancourt, Christian ; Davis, Dan ; Aufderheide, Tom P. ; Idris, Ahamed ; Stouffer, John A. ; Stiell, Ian ; Berg, Robert. / Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation. In: Circulation. 2009 ; Vol. 120, No. 13. pp. 1241-1247.
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AU - Hostler, David

AU - Powell, Judy

AU - Callaway, Clifton W.

AU - Bishop, Dan

AU - Vaillancourt, Christian

AU - Davis, Dan

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AU - Stiell, Ian

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AB - 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.

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KW - Fibrillation

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