Impact of cardiopulmonary resuscitation duration on the neurological outcomes of out-of-hospital cardiac arrest

Hissah Albinali; Arwa Alumran; Saja Alrayes

doi:10.1186/s12245-022-00418-4

Impact of cardiopulmonary resuscitation duration on the neurological outcomes of out-of-hospital cardiac arrest

Int J Emerg Med. 2022 Mar 19;15(1):12. doi: 10.1186/s12245-022-00418-4.

Authors

Hissah Albinali¹, Arwa Alumran², Saja Alrayes²

Affiliations

¹ Royal Commission Hospital, P.O.Box 11994, Jubail Industrial City, 31961, Saudi Arabia. hissah.albinali@hotmail.com.
² Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.

Abstract

Background: Patients experiencing cardiac arrest outside medical facilities are at greater risk of death and might have negative neurological outcomes. Cardiopulmonary resuscitation duration affects neurological outcomes of such patients, which suggests that duration of CPR may be vital to patient outcomes.

Objectives: The study aims to evaluate the impact of cardiopulmonary resuscitation duration on neurological outcome of patients who have suffered out-of-hospital cardiac arrest.

Methods: This is a quantitate cross-sectional study where data is collected from emergency cases handled by a secondary hospital in industrial Jubail, Saudi Arabia, between January 2015 and December 2020. There were 257 out-of-hospital cardiac arrest cases, 236 of which resulted in death. The outcome is the survival of OHCA or death, and the neurological outcome by the cerebral performance category (CPC) score for survivors. A score of 1 or 2 defined as good CPC outcome and 3, 4, and 5 as poor outcome.

Results: The mean for the duration of emergency CPR procedures in surviving patients is 26.5 ± 7.20 min, whereas in patients who died after the procedure it is 29.6 ± 9.15 min. Bivariate analysis showed no significant association between duration of CPR and Cerebral Performance Category (CPC) outcome but could be significant if the sample size is large. Age, however, is significantly related to the survivorship of OHCA and to a better CPC outcome. Younger patients are more likely to have better CPC outcome. A good CPC outcome was reported with a limited duration of 8.1 min of CPR, whereas, poor CPC outcomes were associated with prolonged periods of CPR, 13.2 min.

Conclusion: Cardiopulmonary Resuscitation Duration out-of-hospital cardiac arrest does not significantly influence the patient neurological outcome in the current study hospital. Variables such as the patient population's uniqueness, underlying medical conditions, or the specific study conditions may explain this variance between the bivariate analysis and the study conclusion. Therefore, a more comprehensive study is recommended in future.

Keywords: Cardiac arrest; Cardiopulmonary resuscitation; Cerebral performance category; Neurological outcome; Patient outcomes.