Key Factors Determining the Success of Cardiopulmonary Resuscitation: A Multi-center Study Investigating Survival Rates and Predictors

影响心肺复苏成功与否的关键因素:一项多中心研究探讨生存率和预测因素

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Abstract

Introduction Cardiac arrest can be fatal if not addressed quickly, and cardiopulmonary resuscitation (CPR) is a critical intervention to sustain life in cases of cardiac arrest. Multiple factors affect the mortality of patients who had cardiac arrest and subsequently CPR, such as the timing at which CPR is started. Due to the scarcity of local evidence regarding cardiac arrest in Saudi Arabia, this study aims to identify the predictors of CPR success and survival rate, namely, return of spontaneous circulation (ROSC). Factors that will be investigated are gender, timing, initial rhythm, and whether the cardiac arrest was witnessed. Methods A multicenter retrospective cohort study was conducted on patients who had cardiac arrest and CPR in National Guard Health Affairs in Saudi Arabia. The study was conducted in the Riyadh, Jeddah, and Al-Ahsa regions. The study's total sample was 949 patients, as 857 patients were from Riyadh, 58 patients were from Jeddah, and 34 patients were from Al-Ahsa. Furthermore, the sampling technique was a consecutive non-random sampling technique. Results Of the 949 cases of CPR for patients with cardiac arrest, 544 of 949 (57.3%) achieved ROSC after the first CPR attempt. Statistically speaking, female patients were more likely to have ROSC than male patients, with a percentage of 25.7% versus 19.1%, respectively (p = 0.0231). Also, patients who had ROSC had a mean duration before starting CPR of 4.95 minutes. However, patients who passed away had a mean duration before initiating CPR of 19.81 minutes (p < 0.0001). Conclusion Statistical analysis revealed that multiple factors can affect the mortality of patients who had cardiac arrest, one of which is gender, duration before initiating CPR, whether the cardiac arrest was witnessed, and the initial rhythm of the cardiac arrest. However, further local and international prospective designs are essential to study the variable factors that can affect the success rate of CPR, mainly ROSC. One of the factors that could not be measured in this study is cultural differences in response times.

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