The impact of response time reliability on CPR incidence and resuscitation success - a benchmark study from the German Resuscitation Registry.

Summary of "The impact of response time reliability on CPR incidence and resuscitation success - a benchmark study from the German Resuscitation Registry."


Sudden cardiac arrest is one of the most frequent causes of death in the world. In highly qualified emergency medical service (EMS) systems, including well trained emergency physicians, spontaneous circulation may be restored in up to 53% of patients at least until admission to hospital. Compared with these highly qualified EMS systems, in other systems markedly lower success rates are observed. These data clearly show that there are considerable differences between EMS systems concerning treatment success following cardiac arrest and resuscitation, although in all systems international guidelines for resuscitation are used. This study investigates the impact of response time reliability (RTR) on cardio pulmonary resuscitation (CPR) incidence and resuscitation success using return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score and data from seven German EMS systems participating in the German Resuscitation Registry.
Anonymized patient data after out of hospital cardiac arrest from 2006 to 2009 of seven EMS systems in Germany were analysed to socioeconomic factors (population, area, EMS unit hours), process quality (response time reliability, CPR incidence, special CPR measures, prehospital cooling), patient factors (age, gender, cause of cardiac arrest, bystander CPR). Endpoints were defined as ROSC, admission to hospital, 24 hour survival and hospital discharge rate. For statistical analyses, chi-square, odds-ratio and Bonferroni correction were used.
2,330 prehospital CPR from seven centres were included in this analysis. Incidence of sudden cardiac arrest differs from 36.0 to 65.1 / 100,000 inhabitants / year. We identified two EMS systems (RTR<70%) reaching the patients within eight minutes in 62.0 and 65.6% while the other five EMS systems (RTR>70%) achieved 70.4 up to 95.5%. EMS systems arriving relatively later at the patients side (RTR<70%) less frequently initiate CPR and admit fewer patients alive to hospital (calculated per 100,000 inhabitants / year)( CPR incidence [1/100.000 I/Y] RTR>70%: 57.2; RTR<70%: 36.1; p < 0.01; OR 1.586 (99%
1.383 to 1.819) ( admitted to hospital [1/100.000 I/Y] RTR>70%: 24.4; RTR<70%: 15.6; p < 0.01; OR 1.57 (99%
1.274 to 1.935)). Using ROSC rate and the multi-variate RACA score to predict outcome, the two groups did not differ, but ROSC rate were higher than predicted in both groups (ROSC [%] RTR>70%: 46.6; RTR<70%: 47.3; n.s.; OR 0.971 (95%
0.787 to 1.196)) ( ROSC RACA [%] RTR>70%: 42.4; RTR<70%: 39.5; n.s.; OR 1.127 (95%
0.911 to 1.395)).
This study demonstrates that on the level of EMS systems, faster ones will more often initiate CPR and will increase number of patients admitted to hospital alive. Furthermore it is shown that with very different approaches, all adhering to and intensely training in the ERC guidelines 2005, superior and, according to international comparison, excellent success rates following resuscitation may be achieved.


Journal Details

This article was published in the following journal.

Name: Critical care (London, England)
ISSN: 1466-609X
Pages: R282


DeepDyve research library

PubMed Articles [31303 Associated PubMed Articles listed on BioPortfolio]

Does the choice of definition for defibrillation and CPR success impact the predictability of ventricular fibrillation waveform analysis?

Quantitative analysis of ventricular fibrillation (VF), such as amplitude spectral area (AMSA), predicts shock outcomes. However, there is no uniform definition of shock/cardiopulmonary resuscitation ...

Epinephrine for resuscitation: a century of use and decades of doubts. Let's look to the real physiological response, now!

USG guided Cardiopulmonary resuscitation:time to correct reversible causes.

When should resuscitation at birth cease?

It is rare for newborn infants to require prolonged resuscitation at birth. While there are detailed national and international guidelines on when and how to provide resuscitation to newborns, there i...

Analysis of out-of-hospital cardiac arrest in Croatia - survival, bystander cardiopulmonary resuscitation, and impact of physician's experience on cardiac arrest management: a single center observational study.

To analyze the initial rhythm, bystander cardiopulmonary resuscitation (CPR) rate, and survival after out-of-hospital cardiac arrests (OHCA) in Varaľdin County (Croatia), and to investigate whether p...

Clinical Trials [6814 Associated Clinical Trials listed on BioPortfolio]

Resuscitation Decisions in the Emergency Department (ED)

The investigators will retrospectively examine the connection between resuscitation decisions of admitted patients at the ED of the University Hospital of Basel and several demographic and...

Non-inflatable Supraglottic Airway (NI-SGA) vs. Face Mask (FM) as a Primary Interface Device for Neonatal Resuscitation

Prospective, randomized controlled trial to be performed at one center, of term and late preterm infants requiring resuscitation. Prenatal consent will be obtained. At randomization, babie...

The Evaluation of Technical and Non-technical Skills in Real-life Resuscitation Situations at University Hospital

Cardiac arrest is handled by cardiopulmonary resuscitation which is a time critical emergency situation. The actions during resuscitation are lead by international guidelines. Traditionall...

Influence of the Education in Layperson in Out of Hospital Resuscitation

Cardiac arrest occurs frequently and the outcome after out-of-hospital resuscitation is often fatal. Disturbing is that more than half of the surviving patients suffer from permanent impai...

Oxygen Toxicity in the Resuscitation in Extremely Premature Infants

The investigators hypothesize that using low oxygen concentrations during resuscitation of extremely premature infants will avoid oxidative stress derived damage and improve outcome.

Medical and Biotech [MESH] Definitions

The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.

Success in bringing an effort to the desired end; the degree or level of success attained in some specified area (esp. scholastic) or in general.

The time from the onset of a stimulus until a response is observed.

A quantitative measure of the frequency on average with which articles in a journal have been cited in a given period of time.

Tendency toward a lessened strength of response due to practice or activity. It is independent of the effect of reward and is a direct function of time interval since the last response and the number of preceding responses.

Quick Search

DeepDyve research library

Relevant Topics

Cardiology is a specialty of internal medicine.  Cardiac electrophysiology : Study of the electrical properties and conduction diseases of the heart. Echocardiography : The use of ultrasound to study the mechanical function/physics of the h...

Pulmonary relating to or associated with the lungs eg Asthma, chronic bronchitis, emphysema, COPD, Cystic Fibrosis, Influenza,  Lung Cancer, Pneumonia, Pulmonary Arterial Hypertension, Sleep Disorders etc Follow and track Lung Cancer News ...

Searches Linking to this Article