Association of Public Health Initiatives With Outcomes for Out-of-Hospital Cardiac Arrest at Home and in Public Locations

摘要: Importance Little is known about the influence of comprehensive public health initiatives according to out-of-hospital cardiac arrest (OHCA) location, particularly at home, where resuscitation efforts and outcomes have historically been poor. Objective To describe temporal trends in bystander cardiopulmonary (CPR) first-responder defibrillation for OHCAs stratified by home vs location their association with survival neurological outcomes. Design, Setting, Participants This observational study reviewed 8269 patients (5602 [67.7%] 2667 [32.3%] public) whom was attempted using data from Cardiac Arrest Registry Enhance Survival (CARES) January 1, 2010, through December 31, 2014. The setting 16 counties North Carolina. Exposures Patients were OHCA. Public improve interventions included training members general population CPR use automated external defibrillators, teaching first responders team-based (eg, defibrillator high-performance CPR), instructing dispatch centers on recognition arrest. Main Outcomes Measures Association 2010 Results Among OHCA (n = 5602), median age 64 years, 62.2% male; among (n = 2667), 68 61.5% male. After initiatives, proportion receiving increased (from 28.3% [275 973] 41.3% [498 1206], P  = .01), while 42.2% [132 313] 50.8% [212 417],  = .02) but not significantly 33.1% [58 175] 37.8% [93 246],  = .17). discharge improved arrests 5.7% [60 1057] 8.1% [100 1238],  = .047) 10.8% [50 464] 16.2% [98 604],  = .04). Compared emergency medical services–initiated resuscitation, more likely survive hospital if they received bystander-initiated (odds ratio, 1.55; 95% CI, 1.01-2.38). most both 4.33; 2.11-8.87). Conclusions Relevance coordinated public, which associated survival.