Improved Survival Among Danish Cardiac-Arrest Patients

October 01, 2013

COPENHAGEN, DENMARK — More and more individuals in Denmark are surviving out-of-hospital cardiac arrest, possibly because of an increase in bystanders performing cardiopulmonary resuscitation (CPR), according to the results of a new study[1].

Between 2001 and 2010, there was a significant increase in the number of out-of-hospital cardiac-arrest patients who arrived alive at the hospital, who survived to 30 days, and who were alive at one year.

The analysis, which included 19 469 patients who had an out-of-hospital cardiac arrest in the Danish Cardiac Arrest Registry, also showed that individuals who received CPR from a bystander were nearly four times more likely to survive to 30 days than those in whom no CPR was performed. The benefit of CPR occurred regardless of whether or not the arrest was witnessed.

In the study, published in the October 2, 2003 issue of the Journal of the American Medical Association, lead investigator Dr Mads Wissenberg (Copenhagen University, Hellerup, Denmark) and colleagues say the nationwide study has four major findings:

  • Rates of bystander CPR increased substantially — Bystander CPR increased from 21.1% in 2001 to 44.9% in 2010.

  • Survival at 30 days and one year more than tripled — Survival at 30 days increased from 3.5% in 2001 to 10.8% in 2010; similarly, survival at one year increased from 2.9% in 2001 to 10.2% in 2010.

  • Number of survivors per 100 000 persons more than doubled — At 30 days, survival increased from 1.4/100000 persons in 2001 to 3.7/100 000 persons in 2010; for one-year survival, the number increased from 1.2 to 3.5 per 100 000 persons.

  • Rates of defibrillation among bystanders remained low — Use of automated external defibrillation was 1.1% in 2001 and 2.2% in 2010.

"The large temporal increase in bystander CPR in conjunction with the large increase in numbers of patients achieving survival on arrival at the hospital is a strong indicator of improvements made in prehospital settings," write Wissenberg et al.

The group adds there has been an effort to increase attention to resuscitation by bystanders in Denmark, with more individuals taking first-aid training. Between 2008 and 2010, more than 15% of the Danish population took a CPR course. Still, the "study does not allow for any conclusion to be drawn related to which specific factors have contributed most to the increase in survival," they note. Bystander CPR is likely one important factor contributing to the improved outcomes.

Wissenberg reported no conflicts of interest. Disclosures for the coauthors are listed in the paper.

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