Predictors of in-hospital mortality include worse LVEF, longer time to return of spontaneous circulation, older age
By Elana Gotkine HealthDay Reporter
MONDAY, March 31, 2025 (HealthDay News) — For patients with out-of-hospital cardiac arrest (OHCA), the proportion receiving layperson bystander life support (BLS) has increased, but a critical factor in determining survival and long-term outcomes is how quickly cardiopulmonary resuscitation (CPR) is initiated, according to a study presented at the annual ESC Acute CardioVascular Care congress, held from March 14 to 15 in Florence, Italy.
Aneta Aleksova, M.D., from the University of Trieste in Italy, and colleagues examined whether the percentage of layperson initial rescuers has changed over time in the setting of OHCA during ST-elevation myocardial infarction (STEMI). Data were included for 172 patients with OHCA among 3,315 with STEMI admitted in Italy between 2003 and 2024.
The researchers found that 26 percent of the patients with OHCA were initially rescued by a layperson. The percentage of layperson BLS increased constantly, from 26 percent in 2003-2007 to 69 percent in 2020-2024. The median time to return of spontaneous circulation (ROSC) was 10 minutes. Compared with emergency medical service (EMS) CPR, longer ROSC was seen with layperson-initiated BLS (20 versus 5 minutes). Patients who received layperson BLS more frequently underwent endotracheal intubation than those receiving EMS CPR (91 versus 65 percent). Overall, 44 patients died during their hospital stay, with no difference seen by type of initial rescuer. On logistic regression analysis and after correction for rescuer type, predictors of in-hospital mortality included worse left ventricular ejection fraction, longer time to ROSC, and older age (odds ratios, 1.38, 1.38, and 1.46, respectively). Long-term outcome did not differ according to initial rescuer.
“Our data highlights the importance of immediate resuscitation and underlines the importance to promote population awareness and BLS training to further improve survival after OHCA,” the authors write.
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