title: Chest compression alone cardiopulmonary resuscitation is associated with better long-term survival compared with standard cardiopulmonary resuscitation.
abstract: BACKGROUND
  Little is known about the long-term survival effects of type-specific bystander cardiopulmonary resuscitation (CPR) in the community. We hypothesized that dispatcher instruction consisting of chest compression alone would be associated with better overall long-term prognosis in comparison with chest compression plus rescue breathing.
  
  
  RESULTS
  The investigation was a retrospective cohort study that combined 2 randomized trials comparing the short-term survival effects of dispatcher CPR instruction consisting either of chest compression alone or chest compression plus rescue breathing. Long-term vital status was ascertained by using the respective National and State death records through July 31, 2011. We performed Kaplan-Meier method and Cox regression to evaluate survival according to the type of CPR instruction. Of the 2496 subjects included in the current investigation, 1243 (50%) were randomly assigned to chest compression alone and 1253 (50%) were randomly assigned to chest compression plus rescue breathing. Baseline characteristics were similar between the 2 CPR groups. During the 1153.2 person-years of follow-up, there were 2260 deaths and 236 long-term survivors. Randomization to chest compression alone in comparison with chest compression plus rescue breathing was associated with a lower risk of death after adjustment for potential confounders (adjusted hazard ratio, 0.91; 95% confidence interval, 0.83-0.99; P=0.02).
  
  
  CONCLUSIONS
  The findings provide strong support for long-term mortality benefit of dispatcher CPR instruction strategy consisting of chest compression alone rather than chest compression plus rescue breathing among adult patients with cardiac arrest requiring dispatcher assistance.
authors.affiliation: Emergency Medical Services Division of Public Health for Seattle and King County, Seattle, WA, USA. florence.dumas@cch.aphp.fr
authors.forename: Florence
authors.initials: F
authors.lastname: Dumas
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Rea
authors.forename: Carol
authors.initials: C
authors.lastname: Fahrenbruch
authors.forename: Marten
authors.initials: M
authors.lastname: Rosenqvist
authors.forename: Jonas
authors.initials: J
authors.lastname: Faxén
authors.forename: Leif
authors.initials: L
authors.lastname: Svensson
authors.forename: Mickey S
authors.initials: MS
authors.lastname: Eisenberg
authors.forename: Katarina
authors.initials: K
authors.lastname: Bohm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data; D055815:Young Adult