The association between chest compression release velocity and outcomes from out-of-hospital cardiac arrest

Sheldon Cheskes; Matthew R Common; Adam P Byers; Cathy Zhan; Annemarie Silver; Laurie J Morrison

doi:10.1016/j.resuscitation.2014.10.020

The association between chest compression release velocity and outcomes from out-of-hospital cardiac arrest

Resuscitation. 2015 Jan:86:38-43. doi: 10.1016/j.resuscitation.2014.10.020. Epub 2014 Nov 1.

Authors

Sheldon Cheskes¹, Matthew R Common², Adam P Byers³, Cathy Zhan³, Annemarie Silver⁴, Laurie J Morrison⁵

Affiliations

¹ Sunnybrook Centre for Prehospital Medicine, Toronto, ON, Canada; University of Toronto, Department of Family and Community Medicine, Division of Emergency Medicine, Toronto, ON, Canada; Rescu, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada. Electronic address: Sheldon.Cheskes@sunnybrook.ca.
² Rescu, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
³ Rescu, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada.
⁴ Zoll Medical, Chelmsford, MA, United States.
⁵ University of Toronto, Department of Family and Community Medicine, Division of Emergency Medicine, Toronto, ON, Canada; Rescu, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada.

PMID: 25447039
DOI: 10.1016/j.resuscitation.2014.10.020

Abstract

Background: Previous studies have demonstrated significant relationships between cardiopulmonary resuscitation (CPR) quality metrics and survival to hospital discharge from out-of-hospital cardiac arrest (OHCA). Recently, it has been suggested that a new metric, chest compression release velocity (CCRV), may be associated with improved survival from OHCA.

Methods and results: We performed a retrospective review of all treated adult OHCA occurring over a two year period beginning January 1, 2012. CPR metrics were abstracted from accelerometer measurements during each resuscitation. Multivariable regression analysis was used to examine the impact of CCRV on survival to hospital discharge. Secondary outcome measures were the impact of CCRV on return of spontaneous circulation (ROSC) and neurologically intact survival (MRS ≤ 3). Among 1800 treated OHCA, 1137 met inclusion criteria. The median (IQR) age was 71.6 (60.6, 82.3) with 724 (64%) being male. The median (IQR) CCRV (mm/s) amongst 96 survivors was 334.5 (300.0, 383.2) compared to 304.0 (262.6, 354.1) in 1041 non survivors (p < 0.001). When adjusted for Utstein variables, the odds of survival to hospital discharge for each 10 mm/s increase in CCRV was 1.02 (95% CI: 0.98, 1.06). Similarly the odds of ROSC and neurologically intact survival were 1.01 (95% CI: 0.99, 1.03) and 1.02 (95% CI: 0.98, 1.06), respectively.

Conclusions: When adjusted for Utstein variables, CCRV was not significantly associated with outcomes from OHCA. Further research in other EMS systems is required to clarify the potential impact of this variable on OHCA survival.

Keywords: Cardiopulmonary resuscitation; Heart arrest; Resuscitation; Survival.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cardiopulmonary Resuscitation / methods*
Female
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest / mortality
Out-of-Hospital Cardiac Arrest / therapy*
Patient Discharge
Retrospective Studies
Survival Rate
Time Factors