Starting cardiopulmonary resuscitation (CPR) promptly by a bystander on someone experiencing cardiac arrest at home or in a public place significantly improves survival odds and brain health, especially if initiated within 10 minutes of the arrest. This conclusion arises from initial research set to be shared at the American Heart Association’s Resuscitation Science Symposium 2024, scheduled for November 16-17, 2024, at the Hilton Chicago Hotel. The symposium will highlight the latest developments in treating cardiac arrest and severe traumatic injuries.
Cardiac arrest, which occurs when the heart stops beating unexpectedly, can be fatal without immediate interventions like CPR to boost blood flow to vital organs, particularly the heart and brain. In the U.S., over 357,000 out-of-hospital cardiac arrests are reported annually, yet the survival rate stands at only 9.3%. “Our research emphasizes that rapid initiation of bystander CPR is crucial; even a brief delay can have significant consequences,” stated Evan O’Keefe, M.D., the study’s lead author and a cardiovascular fellow at Saint Luke’s Mid America Heart Institute and the University of Missouri-Kansas City. “If you witness someone requiring CPR, don’t hesitate; your swift response could be life-saving.”
The study examined almost 200,000 instances of observed out-of-hospital cardiac arrests to assess how different start times for CPR impacted survival rates and brain function post-discharge from the hospital.
“Those who received bystander CPR within the earliest moments of their cardiac arrest had much better chances of survival and retained better cognitive function than those who didn’t get CPR,” O’Keefe explained. “Delaying CPR reduced the survival benefits, although even CPR initiated up to 10 minutes after arrest still offered substantial advantages compared to no assistance at all.”
Key findings included:
- Individuals receiving CPR within two minutes of an out-of-hospital cardiac arrest had an 81% greater chance of being discharged from the hospital and a 95% higher chance of surviving without significant cognitive impairment compared to those who did not receive bystander CPR.
- Even for patients who had bystander CPR initiated up to 10 minutes after cardiac arrest, there was a 19% better rate of survival to hospital discharge and a 22% greater likelihood of good neurological outcomes compared to those who received no CPR.
- Among individuals who did not receive bystander CPR, about 12% survived long enough to be discharged from the hospital, and over 9% survived without long-lasting cognitive impairments or severe disabilities. However, for those receiving CPR after more than 10 minutes, the benefits of intervention dropped significantly and did not equate to better outcomes.
“These outcomes underscore the urgent necessity for quick responses in emergencies,” O’Keefe noted. “We must prioritize educating more people on CPR techniques and also enhance the speed at which help reaches cardiac arrest victims. This could involve expanding CPR training initiatives and ensuring broader access to automated external defibrillators (AEDs), as well as refining emergency response systems.”
O’Keefe also pointed out that future studies could investigate how technology—like apps that notify trained bystanders or alert emergency services of potential cardiac arrests—could minimize the time before assistance is rendered, which is vital information for emergency responders and policymakers focusing on public health strategies surrounding cardiac arrest.
“This research emphasizes the need for quick recognition and treatment of cardiac arrests by bystanders,” said Anezi Uzendu, M.D., a volunteer expert for the American Heart Association, interventional cardiologist at the University of Texas Southwestern Medical Center, and a cardiac arrest survivor. “In cases of cardiac arrest, timing is crucial, and delays can be detrimental. Educating and empowering communities is essential for saving lives.”
The American Heart Association encourages everyone to equip themselves with the life-saving skills of CPR and to become part of its Nation of Lifesavers®, aiming to double survival rates from sudden cardiac arrest by 2030. Being prepared to act quickly can be the deciding factor in someone’s survival during a cardiac arrest.
A limitation of the study is that emergency medical technicians (EMTs) typically took around 10 minutes to arrive. Consequently, individuals who received bystander CPR after 10 minutes were likely being evaluated against a group that received professional medical care.
Details and background on the study include:
- The study encompassed 160,822 witnessed out-of-hospital cardiac arrests between 2013 and 2022. The average age of the individuals analyzed was 64 years, with over 54,000, or about 34%, being women.
- Researchers utilized data from the Cardiac Arrest Registry to Enhance Survival (CARES), a national health registry designed to aid communities in enhancing care for and improving survival rates of out-of-hospital cardiac arrests.
- The research categorized the time to the commencement of bystander CPR in two-minute intervals and examined the relationship between each interval, compared to individuals who received no CPR, with survival outcomes and neurological condition post-hospitalization.
