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{ "pk": 18413, "title": "Impact of Bystander Cardiopulmonary Resuscitation on Out-of- Hospital Cardiac Arrest Outcome in Vietnam", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> Patients experiencing an out-of-hospital cardiac arrest (OHCA) frequently do not receive bystander cardiopulmonary resuscitation (CPR), especially in low- and middle-income countries (LMIC). In this study we sought to determine the prevalence of OHCA patients in Vietnam who received bystander CPR and its effects on survival outcomes.</p>\n<p><strong>Methods: </strong>We performed a multicenter, retrospective observational study of patients (≥18 years) presenting with OHCA at three major hospitals in an LMIC from February 2014–December 2018. We collected data on the hospital and patient characteristics, the cardiac arrest events, the emergency medical services (EMS) system, the therapy methods, and the outcomes and compared these data, before and after pairwise 1:1 propensity score matching, between patients who received bystander CPR and those who did not. Upon admission, we assessed factors associated with good neurological survival at hospital discharge in univariable and multivariable logistic models.</p>\n<p><strong>Results:</strong> Of 521 patients, 388 (74.5%) were men, and the mean age was 56.7 years (SD 17.3). Although most cardiac arrests (68.7%, 358/521) occurred at home and 78.8% (410/520) were witnessed, a low proportion (22.1%, 115/521) of these patients received bystander CPR. Only half of the patients were brought by EMS (8.1%, 42/521) or private ambulance (42.8%, 223/521), 50.8% (133/262) of whom had resuscitation attempts. Before matching, there was a significant difference in good neurological survival between patients who received bystander CPR (12.2%, 14/115) and patients who did not (4.7%, 19/406; P < .001). After matching, good neurological survival was absent in all OHCA patients who did not receive CPR from a bystander. The multivariable analysis showed that bystander CPR (adjusted odds ratio: 3.624; 95% confidence interval 1.629–8.063) was an independent predictor of good neurological survival.</p>\n<p><strong>Conclusion:</strong> In our study, only 22.1% of total OHCA patients received bystander CPR, which contributed significantly to a low rate of good neurological survival in Vietnam. To improve the chances of survival with good neurological functions of OHCA patients, more people should be trained to perform bystander CPR and teach others as well. A standard program for emergency first-aid training is necessary for this purpose.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Bystander Cardiopulmonary Resuscitation" }, { "word": "emergency medical services" }, { "word": "low- and middle-income countries" }, { "word": "Out-of-hospital Cardiac Arrest" }, { "word": "Pan-Asian Resuscitation Outcomes Study" }, { "word": "return of spontaneous circulation" }, { "word": "Vietnam" } ], "section": "Cardiology", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/663530m7", "frozenauthors": [ { "first_name": "Co", "middle_name": "Xuan", "last_name": "Dao", "name_suffix": "", "institution": "*Bach Mai Hospital, Center for Critical Care Medicine, Hanoi, Vietnam; Hanoi Medical University, Department of Emergency and Critical Care Medicine, Hanoi, Vietnam; Vietnam National University, University of Medicine and Pharmacy, Department of Emergency and Critical Care Medicine, Hanoi, Vietnam", "department": "None" }, { "first_name": "Chinh", "middle_name": "Quoc", "last_name": "Luong", "name_suffix": "", "institution": "Hanoi Medical University, Department of Emergency and Critical Care Medicine, Hanoi, Vietnam; Vietnam National University, University of Medicine and Pharmacy, Department of Emergency and Critical Care Medicine, Hanoi, Vietnam; Bach Mai Hospital, Center for Emergency Medicine, Hanoi, Vietnam", "department": "Center for Emergency Medicine" }, { "first_name": "Toshie", "middle_name": "", "last_name": "Manabe", "name_suffix": "", "institution": "Nagoya City University Graduate School of Medicine, Department of Medical Innovation, Nagoya, Aichi, Japan; Nagoya City University West Medical Center, Center for Clinical Research, Nagoya, Aichi, Japan", "department": "None" }, { "first_name": "My", "middle_name": "Ha", "last_name": "Nguyen", "name_suffix": "", "institution": "Thai Binh University of Medicine and Pharmacy, Department of Health Organization and Management, Thai Binh, Vietnam", "department": "" }, { "first_name": "Dung", "middle_name": "Thi", "last_name": "Pham", "name_suffix": "", "institution": "Thai Binh University of Medicine and Pharmacy, Department of Nutrition and Food Safety, Thai Binh, Vietnam", "department": "None" }, { "first_name": "Tra", "middle_name": "Thanh", "last_name": "Ton", "name_suffix": "", "institution": "Cho Ray Hospital, Emergency Department, Ho Chi Minh City, Vietnam", "department": "None" }, { "first_name": "Quoc", "middle_name": "Trong Ai", "last_name": "Hoang", "name_suffix": "", "institution": "Hue Central General Hospital, Emergency Department, Hue City, Thua Thien Hue, Vietnam", "department": "None" }, { "first_name": "Tuan", "middle_name": "Anh", "last_name": "Nguyen", "name_suffix": "", "institution": "Hanoi Medical University, Department of Emergency and Critical Care Medicine, Hanoi, Vietnam; Bach Mai Hospital, Center for Emergency Medicine, Hanoi, Vietnam", "department": "None" }, { "first_name": "Anh", "middle_name": "Dat", "last_name": "Nguyen", "name_suffix": "", "institution": "Hanoi Medical University, Department of Emergency and Critical Care Medicine, Hanoi, Vietnam; Bach Mai Hospital, Center for Emergency Medicine, Hanoi, Vietnam", "department": "None" }, { "first_name": "Bryan", "middle_name": "Francis", "last_name": "McNally", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia; Emory University Rollins School of Public Health, Atlanta, Georgia", "department": "" }, { "first_name": "Marcus", "middle_name": "Eng Hock", "last_name": "Ong", "name_suffix": "", "institution": "Singapore General Hospital, Department of Emergency Medicine, Singapore, Singapore; Duke-NUS Medical School, Health Services and Systems Research, Singapore, Singapore", "department": "None" }, { "first_name": "Son", "middle_name": "Ngoc", "last_name": "Do", "name_suffix": "", "institution": "Bach Mai Hospital, Center for Critical Care Medicine, Hanoi, Vietnam; Hanoi Medical University, Department of Emergency and Critical Care Medicine, Hanoi, Vietnam; Vietnam National University, University of Medicine and Pharmacy, Department of Emergency and Critical Care Medicine, Hanoi, Vietnam", "department": "" }, { "first_name": "The Local PAROS Investigators", "middle_name": "", "last_name": "Group", "name_suffix": "", "institution": "Names and affiliations listed in supplemental file", "department": "None" } ], "date_submitted": "2023-09-09T04:57:05+02:00", "date_accepted": "2024-03-04T23:22:23.914000+01:00", "date_published": "2024-06-14T15:00:00+02:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18413/galley/14456/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18413/galley/10802/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18413/galley/14456/download/" } ] }