The Role of Bystander Cardiopulmonary Resuscitation: A Meta-Analysis.

Abstract

Objective: This meta-analysis systematically evaluated the impact of bystander cardiopulmonary resuscitation (BCPR) on the survival of patients with out-of-hospital cardiac arrest (OHCA) and related factors. Methods: A computerized search of China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), PubMed, and Embase was conducted from the database's inception to May 1, 2023. The study included observational studies of patients who experienced OHCA and were successfully resuscitated using BCPR, following the predetermined criteria for inclusion and exclusion. The quality of the included studies was assessed using the Newcastle-Ottawa scale, with odds ratios (ORs) and 95% confidence intervals (95%CI) used as effect size measures. The data were statistically analyzed using Review Manager 5.4 software. Results: Fourteen observational studies were included in this study, involving 253,247 cases of OHCA. The primary outcome measure was survival to discharge or survival at 30 days. A meta-analysis was conducted to analyze the data from these 14 studies. The findings indicated that the no-BCPR group had a significantly reduced survival rate compared to the BCPR group (OR: 1.72, 95% CI: 1.40-2.12, p < 0.05). Secondly, the study examined 14 studies that focused on prehospital return of spontaneous circulation and neurological recovery before they reached the hospital. The findings revealed that patients who received BCPR had a higher rate of prehospital ROSC (OR: 2.06, 95% CI: 1.66-2.57, p < 0.05) and experienced better neurological recovery (OR: 2.03, 95% CI: 1.67-2.47, p < 0.05) compared to those who did not receive BCPR. This difference was found to be statistically significant. Conclusion: BCPR can potentially enhance the likelihood of survival for patients experiencing OHCA. BCPR can offer patients an opportunity for both survival and favorable neurological recovery during the time when emergency medical services (EMS) respond. Given the existing circumstances, it is advisable to enhance the promotion and training of public CPR and improve the prevalence of bystander CPR in society since this is expected to yield substantial social advantages.