eprintid: 20108
rev_number: 13
eprint_status: archive
userid: 1589
dir: disk0/00/02/01/08
datestamp: 2016-02-17 10:17:28
lastmod: 2024-03-04 19:14:16
status_changed: 2016-02-17 10:17:28
type: article
metadata_visibility: show
creators_name: Böttiger, Bernd W.
creators_name: Bernhard, Michael
creators_name: Knapp, Jürgen
creators_name: Nagele, Peter
title: Influence of EMS-physician presence on survival after out-of-hospital cardiopulmonary resuscitation: systematic review and meta-analysis
subjects: ddc-610
divisions: i-910300
abstract: Background: Evidence suggests that EMS-physician-guided cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OOHCA) may be associated with improved outcomes, yet randomized controlled trials are not available. The goal of this meta-analysis was to determine the association between EMS-physician- versus paramedic-guided CPR and survival after OOHCA.   Methods and Results: Studies that compared EMS-physician- versus paramedic-guided CPR in OOHCA published until June 2014 were systematically searched in MEDLINE, EMBASE and Cochrane databases. All studies were required to contain survival data. Data on study characteristics, methods, and as well as survival outcomes were extracted. A random-effects model was used for the meta-analysis due to a high degree of heterogeneity among the studies (I  2 = 44 %). Return of spontaneous circulation [ROSC], survival to hospital admission, and survival to hospital discharge were the outcome measures. Out of 3,385 potentially eligible studies, 14 met the inclusion criteria. In the pooled analysis (n = 126,829), EMS-physician-guided CPR was associated with significantly improved outcomes compared to paramedic-guided CPR: ROSC 36.2% (95% confidence interval [CI] 31.0 – 41.7%) vs. 23.4% (95% CI 18.5 – 29.2%) (pooled odds ratio [OR] 1.89, 95% CI 1.36 – 2.63, p < 0.001); survival to hospital admission 30.1% (95% CI 24.2 – 36.7%) vs. 19.2% (95% CI 12.7 – 28.1%) (pooled OR 1.78, 95% CI 0.97 – 3.28, p = 0.06); and survival to discharge 15.1% (95% CI 14.6 – 15.7%) vs. 8.4% (95% CI 8.2 – 8.5%) (pooled OR 2.03, 95% CI 1.48 – 2.79, p < 0.001).   Conclusions: This systematic review suggests that EMS-physician-guided CPR in out-of-hospital cardiac arrest is associated with improved survival outcomes.
date: 2016
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 1657159620
own_urn: urn:nbn:de:bsz:16-heidok-201081
language: eng
bibsort: BOTTIGERBEINFLUENCEO2016
full_text_status: public
publication: Critical care
volume: 20
number: 4
place_of_pub: London
pagerange: 1-8
issn: 1466-609X
citation:   Böttiger, Bernd W. ; Bernhard, Michael ; Knapp, Jürgen ; Nagele, Peter  (2016) Influence of EMS-physician presence on survival after out-of-hospital cardiopulmonary resuscitation: systematic review and meta-analysis.  Critical care, 20 (4).  pp. 1-8.  ISSN 1466-609X     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/20108/1/13054_2015_Article_1156.pdf