Impact of a national initiative to provide civilian cardiopulmonary resuscitation training courses on the rates of bystander intervention by citizens and survival after out-of-hospital cardiac arrest
Authors' conclusion
The incidence of citizen-initiated CPR across Japan has consistently and proportionately increased with the rising number of individuals certified in CPR courses. Greater citizen CPR involvement has been linked to neurologically favorable survival, particularly in cases with an initial shockable rhythm.
Study context
- Population
- Citizen-witnessed out-of-hospital cardiac arrest (OHCA) of presumed cardiac origin, Japanese nationwide registry, 2005–2020
- Participants
- 358,025 participants
- Exposure
- Citizen cardiopulmonary resuscitation (CPR) types vs no citizen CPR
- Outcome
- Neurologically favorable survival
- Follow-up
- 1 month
Methodological detailsnationwide registry
- Nationwide registry
Main finding
As reported in the abstract
Neurologically favorable survival, initial shockable rhythm
Each group vs no citizen CPROdds ratio (95% CI)P value
Chest compression only
1.24(1.02–1.51)
P = 0.029Chest compression with rescue breathing
1.33(1.08–1.62)
P = 0.006Defibrillation with chest compression
2.27(1.83–2.83)
P < 0.001Defibrillation with chest compression and rescue breathing
2.15(1.70–2.73)
P < 0.001Observational data: associations, not effects.
Further findings
Cumulative CPR-certified citizens · 2005 to 2020
- Increased from 9,930,327 (2005) to 34,938,322 (2020); 32.3% of population aged ≥15
- IRR for annual number = 1.03, p < 0.001
Prevalence of citizen-initiated CPR · 2005 to 2020
- Increased from 40.6% (2005) to 56.8% (2020)
- P for trend < 0.001
Original publication
Impact of a national initiative to provide civilian cardiopulmonary resuscitation training courses on the rates of bystander intervention by citizens and survival after out-of-hospital cardiac arrest. Resuscitation. Published 12 January 2024. doi:10.
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