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Association of bystander interventions and hospital length of stay and admission to intensive care unit in out-of-hospital cardiac arrest survivors

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  • Signe Riddersholm, Department of Anesthesiology and Intensive Care Medicine, Aalborg University Hospital, Denmark; Clinical Institute, Aalborg University, Denmark. Electronic address: s.riddersholm@rn.dk.
  • ,
  • Kristian Kragholm, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
  • ,
  • Rikke Nørmark Mortensen, Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
  • ,
  • Marianne Pape, Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
  • ,
  • Carolina Malta Hansen, Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; Duke Clinical Research Institute, Duke University, Durham, NC, United States.
  • ,
  • Freddy Knudsen Lippert, University of Copenhagen
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  • Christian Tobias Torp-Pedersen, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; Institute of Health, Science and Technology, Aalborg University, Denmark.
  • ,
  • Christian F Christiansen
  • Bodil Steen Rasmussen, Department of Anesthesiology and Intensive Care Medicine, Aalborg University Hospital, and Clinical Institute, Aalborg University, Aalborg, Denmark.

BACKGROUND: The impact of bystander interventions on post-arrest hospital course is sparsely studied. We examined the association between bystander interventions and length of hospital stay and admission to intensive care unit (ICU) in one-day survivors after OHCA.

METHODS: This cohort study linked data of 4641 one-day OHCA survivors from 2001 to 2014 to data on hospital length of stay and ICU admission. We examined associations between bystander efforts and outcomes using regression, adjusted for age, sex, comorbidities, calendar year and witnessed status. We divided bystander efforts into three categories: 1. No bystander interventions; 2.Bystander CPR only; 3. Bystander defibrillation with or without bystander CPR.

RESULTS: For patients surviving to hospital discharge, hospital length of stay was 20days for patients without bystander interventions, compared to 16 for bystander CPR, and 13 for bystander defibrillation. 82% of patients without bystander interventions were admitted to ICU compared to 77.2% for bystander CPR, and 61.2% for bystander defibrillation. In-hospital mortality was 60% in the first category compared to 40.5% and 21.7% in the two latter categories. In regression models, bystander CPR and bystander defibrillation were associated with a reduction of length of hospital stay of 21% (Estimate: 0.79 [95% CI: 0.72-0.86]) and 32% (Estimate: 0.68 [95% CI: 0.59-0.78]), respectively. Both bystander CPR (OR: 0.94 [95% CI: 0.91-0.97]) and bystander defibrillation (OR: 0.81 [0.76-0.85]), were associated with lower risk of ICU admission.

CONCLUSIONS: Bystander interventions were associated with reduced hospital length of stay and ICU admission, suggesting that these efforts improve recovery in OHCA survivors.

Original languageEnglish
JournalResuscitation
Volume119
ISSN0300-9572
DOIs
Publication statusPublished - 2017

    Research areas

  • Journal Article

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