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FLORENCE, Italy – In a groundbreaking study presented at the ESC Acute CardioVascular Care congress, researchers have revealed that the speed at which cardiopulmonary resuscitation (CPR) is administered during an out-of-hospital cardiac arrest (OHCA) is more critical than who performs it.
The research, led by Prof. Aneta Aleksova from the University of Trieste, Italy, analyzed data from 3,315 patients with ST-elevation myocardial infarction (STEMI) admitted to University Hospital Trieste over 22 years (2003-2024). Of these, 172 experienced OHCA, with 44 receiving bystander-initiated CPR.
The study found a significant increase in bystander CPR over the years, rising from 26% in 2003-2007 to 69% in 2020-2024. While this increase is encouraging, the researchers emphasized that the time to return of spontaneous circulation (ROSC) was the key determinant of survival.
“Our data highlights the importance of immediate resuscitation and underlines the importance to promote population awareness and BLS training to further improve survival after out-of-hospital cardiac arrest,” stated the authors.
The median time to ROSC was 10 minutes overall, but longer for bystanders (20 minutes) compared to medical operators (5 minutes). However, statistical analysis showed that the time to ROSC, left ventricular ejection fraction (LVEF), and age were the main predictors of in-hospital mortality, regardless of who performed CPR.
Specifically, each 5-minute increase in time to ROSC and a 5-percentage-point decrease in LVEF were associated with a 38% increased risk in mortality. Every 5-year increase in age corresponded to a 46% higher death risk.
Despite longer ROSC times, long term survival rates were similar between patients receiving bystander CPR and those receiving EMS CPR.
The study also highlighted that approximately 80% of OHCAs occur in residential settings, underscoring the need for widespread public education and Basic Life Support (BLS) training.
While the survival rates in this study were higher than typically seen for OHCA, the researchers attributed this to the study’s focus on STEMI patients, who generally have better recovery chances, as well as potentially higher-than-average rates of CPR-trained bystanders and efficient emergency medical services.
The authors concluded, “Rapid return of spontaneous circulation was crucial for in-hospital survival, independently of rescuer type. Also, similar long-term survival was observed comparing patients with initial layperson or emergency medical service cardiopulmonary resuscitation.”
Disclaimer: This news article is based on information provided by the European Society of Cardiology and summarizes findings presented at the ESC Acute CardioVascular Care congress. Medical research is continually evolving, and the information presented here should not be considered a substitute for professional medical advice. Always consult with a qualified healthcare provider for any questions you may have regarding a medical condition.1 Individual results may vary, and the findings of this study may not be applicable to all populations.
