[Comparisons of Clinical Effectiveness and Survival between Continuous and Interrupted Chest Compressions in Out-of-hospital Cardiac Arrest].

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.