Key result
Bystander-initiated CPR combined with AED use significantly improved 1-month survival with favorable neurological outcomes compared to no basic life support (64.8% vs 28.0%; AOR 3.97, 95% CI 1.32-11.90).
Why the study?
The study was conducted to investigate the prognostic impact of bystander-initiated CPR and public-access AED use on non-traumatic OHCA occurring during school-supervised sports activities in children.
Does bystander-initiated CPR and AED use improve 1-month survival with favorable neurological outcomes in children with non-traumatic OHCA during school-supervised sports activities?
Observational (n=318)
Yes
Does bystander-initiated CPR and AED use improve 1-month survival with favorable neurological outcomes in children with non-traumatic OHCA during school-supervised sports activities?
Odds Ratio: 3.97 (95% CI 1.32–11.9)
Absolute Event Rate: 64.8% vs 28%
p-value: p=0.014
The combination of bystander CPR and AED application significantly improves 1-month survival with favorable neurological outcomes in children experiencing non-traumatic OHCA during school sports.
Bystander CPR with AED may improve school sports OHCA outcomes in children; extends observational data but leaves open need for prospective confirmation before practice change.
To investigate the prognostic impact of bystander-initiated cardiopulmonary resuscitation (CPR) and public-access automated external defibrillator (AED) use on non-traumatic out-of-hospital cardiac arrest (OHCA) occurring during school-supervised sports activities in children. From a nationwide database of pediatric OHCAs occurring under school supervision in Japan, data between April 2008 and December 2020 were obtained. We analyzed non-traumatic OHCAs that occurred during school-supervised sports activities among schoolchildren from elementary, junior high, high, and technical colleges. A multivariable logistic regression model was used to evaluate the effect of basic life support (BLS) on 1-month survival with favorable neurological outcomes after OHCA. In total, 318 OHCA cases were analyzed. The 1-month survival with favorable neurological outcomes was 64.8% (164/253) in cases receiving both bystander-CPR and AED application, 40.7% (11/27) in cases receiving CPR only, 38.5% (5/13) in patients receiving AED application only, and 28.0% (7/25) in cases receiving no bystander intervention. Compared with cases receiving no BLS, cases receiving both CPR and AED had a significantly higher proportion of 1-month survival with favorable neurological outcomes (adjusted odds ratio [AOR]: 3.97, 95% confidence interval [CI]: 1.32–11.90, p = 0.014). However, compared to cases receiving no BLS, there was no significant difference in the outcome in the cases receiving CPR only (AOR: 1.35, 95% CI: 0.34–5.29, p = 0.671) and the cases receiving AED application only (AOR: 1.26, 95% CI: 0.25–6.38, p = 0.778). The combination of CPR and AED as BLS performed by bystanders for non-traumatic OHCA during school-supervised sports activities improved the outcomes.
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Kiyohara et al. (2023) conducted an observational in Non-traumatic out-of-hospital cardiac arrest (OHCA) (n=318). Bystander-initiated CPR and AED use vs. No bystander intervention (no BLS) was evaluated on 1-month survival with favorable neurological outcomes (AOR 3.97, 95% CI 1.32-11.90, p=0.014). Bystander-initiated CPR combined with AED use significantly improved 1-month survival with favorable neurological outcomes compared to no basic life support (64.8% vs 28.0%; AOR 3.97, 95% CI 1.32-11.90).
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