title: Chest compression quality management and return of spontaneous circulation: a matched-pair registry study.
abstract: OBJECTIVE
  Investigating the effects of any intervention during cardiac arrest remains difficult. The ROSC after cardiac arrest score was introduced to facilitate comparison of rates of return of spontaneous circulation (ROSC) between different ambulance services. To study the influence of chest compression quality management (including training, real-time feedback devices, and debriefing) in comparison with conventional cardiopulmonary resuscitation (CPR), a matched-pair analysis was conducted using data from the German Resuscitation Registry, with the calculated ROSC after cardiac arrest score as the baseline.
  
  
  RESULTS
  Matching for independent ROSC after cardiac arrest score variables yielded 319 matched cases from the study period (January 2007-March 2011). The score predicted a 45% ROSC rate for the matched pairs. The observed ROSC increased significantly with chest compression quality management, to 52% (P=0.013; 95% CI, 46-57%). No significant differences were seen in the conventional CPR group (47%; 95% CI, 42-53%). The difference between the observed ROSC rates was not statistically significant.
  
  
  CONCLUSIONS
  Chest compression quality management leads to significantly higher ROSC rates than those predicted by the prognostic score (ROSC after cardiac arrest score). Matched-pair analysis shows that with conventional CPR, the observed ROSC rate was not significantly different from the predicted rate. Analysis shows a trend toward a higher ROSC rate for chest compression quality management in comparison with conventional CPR. It is unclear whether a single aspect of chest compression quality management or the combination of training, real-time feedback, and debriefing contributed to this result.
authors.affiliation: Department of Anaesthesiology, Intensive Care and Pain Medicine University Hospital Muenster, Germany. lukasr@uni-muenster.de
authors.forename: Roman-Patrik
authors.initials: RP
authors.lastname: Lukas
authors.forename: Jan Thorsten
authors.initials: JT
authors.lastname: Gräsner
authors.forename: Stephan
authors.initials: S
authors.lastname: Seewald
authors.forename: Rolf
authors.initials: R
authors.lastname: Lefering
authors.forename: Thomas Peter
authors.initials: TP
authors.lastname: Weber
authors.forename: Hugo
authors.initials: H
authors.lastname: Van Aken
authors.forename: Matthias
authors.initials: M
authors.lastname: Fischer
authors.forename: Andreas
authors.initials: A
authors.lastname: Bohn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001775:Blood Circulation; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D012042:Registries; D017749:Total Quality Management