[Comparisons of Clinical Effectiveness and Survival between Continuous and Interrupted Chest Compressions in...

Objective To compare the clinical outcomes of continuous chest compressions (CCP) or interrupt chest compression (ICP) for the cardiac arrest patients. Methods Totally 114 adult patients with out-of-hospital non-trauma-related cardiac arrest that needed cardiopulmonary resuscitation (CPR) in Quzhou People's Hospital from January 2014 to January 2017 were enrolled in this study. Patients who divided into CCP group (n=70) and ICP group (n=44) according to the maneuvers. The clinical data of these two groups were collected and compared. Results The chest-compression fraction was higher in CCP group than in ICP group (0.85±0.05 vs. 0.75±0.06,t=9.868,P=0.000),and the rate of chest-compression pause per minute was significantly lower in CCP group (3.5±1.6 vs. 6.9±3.8,t=-10.669,P=0.000). The interval from arrival at a first aid location to CPR,duration of CPR,electric defibrillation frequency,airway establishment,intubation time,and use of first-aid drugs were not statistically significant (all P>0.05). Significantly lower proportion of patients in CCP group were transported to a hospital (42.8% vs. 56.8%,Χ²=0.198,P=0.032). The proportion of patients achieving recovery of spontaneous circulation (ROSC) in CCP group were significantly lower than in ICP group (28.5% vs.47.7%,Χ²=0.191,P=0.038). The proportion of patients who got successful resuscitation in CCP group was significantly lower than in ICP group (20.0% vs. 38.6%,Χ²=4.470,P=0.029). The proportion of patients who survived and were discharged was significantly lower in CCP group than in ICP group (8.6% vs.22.7%,Χ²=0.487,P=0.041). There was no significant difference between these two groups in ROSC time,proportion of survivors one month after discharge,proportion of survivors six months after discharges,and neurological outcomes (all P>0.05). Among the survivors,2 patients had ST-elevation myocardial infarction,1 had rheumatic heart disease,2 had non-ST segment elevations myocardial infarction,and 1 had dilated cardiomyopathy. Multivariate Cox proportional hazard regression analysis was used to analyze the independent factor of prognosis. The time from cardiac arrest to CPR (HR=1.047,95% CI=1.003-1.093,P=0.034),the time from CPR to ROSC (HR=1.021,95% CI=1.003-1.038,P=0.020),and Glasgow Coma Scale (GCS) 1 score (HR=1.551,95% CI=1.022-2.355,P=0.039) were the independent risk factor for deaths within 180 days after discharge. Conclusion Long interval from cardiac arrest to CPR,long interval from CPR to ROSC,and a Glasgow Coma Scale score of>1 are the independent risk factors of deaths within 180 days after discharge. Therefore,the survival outcomes of CCP may not be superior to ICP in patients with out-of-hospital cardiac arrest.