title: Mechanical chest compression devices are associated with poor neurological survival in a statewide registry: A propensity score analysis.
abstract: To compare functional survival (discharge cerebral performance category 1 or 2) among victims of out-of-hospital cardiac arrest (OHCA) who had resuscitations performed using mechanical chest compression (mech-CC) devices vs. those using manual chest compressions (man-CC).
  
  
  
  Observational cohort of 2600 cases of OHCA from a statewide, prospectively-collected cardiac arrest registry (Utah Cardiac Arrest Registry to Enhance Survival). Comparison of functional survival among those receiving mech-CC vs man-CC was performed using a mixed-effects Poisson model with inverse probability weighted propensity scores to control for selection bias.
  
  
  
  Overall, mech-CC was utilized in 405/2600 (16%) of the total arrests in Utah during this period. 371/405 (92%) were of the load-distributing band type (AutoPulse(®)) and 22/405 (5%) were mechanical piston devices (LUCAS™), while 12/405 (3%) employed other devices. The relative risk (RR) for functional survival comparing mech-CC to man-CC after propensity score adjustment was 0.41 (95% CI 0.24-0.70, p=0.001).
  
  
  
  Mechanical chest compression device use was associated with lower rates of functional survival in this propensity score analysis, controlling for Utstein variables and early return of spontaneous circulation.
authors.affiliation: University of Utah School of Medicine, Division of Emergency Medicine, Salt Lake City, UT, United States; The Salt Lake City Fire Department, Salt Lake City, UT, United States. Electronic address: scott.youngquist@utah.edu.
authors.forename: Scott T
authors.initials: ST
authors.lastname: Youngquist
authors.affiliation: University of Utah School of Medicine, Division of Emergency Medicine, Salt Lake City, UT, United States.
authors.forename: Patrick
authors.initials: P
authors.lastname: Ockerse
authors.affiliation: The University of North Carolina School of Medicine, Chapel Hill, NC, United States.
authors.forename: Sydney
authors.initials: S
authors.lastname: Hartsell
authors.affiliation: University of Utah School of Medicine, Division of Emergency Medicine, Salt Lake City, UT, United States.
authors.forename: Chris
authors.initials: C
authors.lastname: Stratford
authors.affiliation: University of Utah School of Medicine, Division of Emergency Medicine, Salt Lake City, UT, United States; The Utah Department of Health, Bureau of Emergency Medical Services, United States.
authors.forename: Peter
authors.initials: P
authors.lastname: Taillac
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000401:mortality* / Q000706:statistics & numerical data; D005260:Female; D006336:Heart Massage / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality*; D016012:Poisson Distribution; D057216:Propensity Score; D012042:Registries; D014589:Utah
keywords: Cardiac Arrest; Chest Compressions; Mechanical Devices