Chen Xi, Zou Zexi, Wen Xueyi, Li Linfei, Liang Yuanyuan
Department of Emergency Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
School of Nursing, Zunyi Medical University, Zunyi, Guizhou, China.
Emerg Med Int. 2025 Jul 26;2025:5591055. doi: 10.1155/emmi/5591055. eCollection 2025.
This meta-analysis systematically evaluated the impact of bystander cardiopulmonary resuscitation (BCPR) on the survival of patients with out-of-hospital cardiac arrest (OHCA) and related factors. A computerized search of China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), PubMed, and Embase was conducted from the database's inception to May 1, 2023. The study included observational studies of patients who experienced OHCA and were successfully resuscitated using BCPR, following the predetermined criteria for inclusion and exclusion. The quality of the included studies was assessed using the Newcastle-Ottawa scale, with odds ratios (ORs) and 95% confidence intervals (95%CI) used as effect size measures. The data were statistically analyzed using Review Manager 5.4 software. Fourteen observational studies were included in this study, involving 253,247 cases of OHCA. The primary outcome measure was survival to discharge or survival at 30 days. A meta-analysis was conducted to analyze the data from these 14 studies. The findings indicated that the no-BCPR group had a significantly reduced survival rate compared to the BCPR group (OR: 1.72, 95% CI: 1.40-2.12, < 0.05). Secondly, the study examined 14 studies that focused on prehospital return of spontaneous circulation and neurological recovery before they reached the hospital. The findings revealed that patients who received BCPR had a higher rate of prehospital ROSC (OR: 2.06, 95% CI: 1.66-2.57, < 0.05) and experienced better neurological recovery (OR: 2.03, 95% CI: 1.67-2.47, < 0.05) compared to those who did not receive BCPR. This difference was found to be statistically significant. BCPR can potentially enhance the likelihood of survival for patients experiencing OHCA. BCPR can offer patients an opportunity for both survival and favorable neurological recovery during the time when emergency medical services (EMS) respond. Given the existing circumstances, it is advisable to enhance the promotion and training of public CPR and improve the prevalence of bystander CPR in society since this is expected to yield substantial social advantages.
本荟萃分析系统评价了旁观者心肺复苏术（BCPR）对院外心脏骤停（OHCA）患者生存率及相关因素的影响。从各数据库建库至2023年5月1日，对中国知网（CNKI）、万方数据库、中国生物医学文献数据库（CBM）、PubMed和Embase进行了计算机检索。本研究纳入了符合预定纳入和排除标准、经历OHCA并通过BCPR成功复苏的患者的观察性研究。采用纽卡斯尔-渥太华量表评估纳入研究的质量，以比值比（OR）和95%置信区间（95%CI）作为效应量指标。使用Review Manager 5.4软件对数据进行统计学分析。本研究纳入了14项观察性研究，涉及253,247例OHCA病例。主要结局指标为出院存活或30天存活。对这14项研究的数据进行了荟萃分析。结果表明，与BCPR组相比，非BCPR组的生存率显著降低（OR：1.72，95%CI：1.40 - 2.12，P<0.05）。其次，该研究考察了14项关注院前自主循环恢复和入院前神经功能恢复的研究。结果显示，与未接受BCPR的患者相比，接受BCPR的患者院前恢复自主循环（ROSC）的比例更高（OR：2.06，95%CI：1.66 - 2.57，P<0.05），神经功能恢复情况更好（OR：2.03，95%CI：1.67 - 2.47，P<0.05）。发现这种差异具有统计学意义。BCPR有可能提高OHCA患者的存活可能性。在紧急医疗服务（EMS）响应期间，BCPR可为患者提供生存和良好神经功能恢复的机会。鉴于目前的情况，建议加强公众心肺复苏的推广和培训，提高社会中旁观者心肺复苏的普及率，因为这有望产生巨大的社会效益。
