The Impact of Dispatcher Assistance in the Rates and Efficacy of Bystander CPR: A Meta-analysis

Objective: To perform a meta-analysis of observational studies addressing whether Dispatcher Assisted Cardiopulmonary Resuscitation (DACPR), compared with independent Bystander Cardiopulmonary Resuscitation (BCPR), increases the rates of BCPR, and whether they alter survival outcomes in out-of-hospital cardiac arrests (OHCA). Methods: Relevant published articles from PubMed and Cochrane databases were studied. The baseline information and outcome data (BCPR rates, survival to hospital discharge, 1-month survival) were extracted from the out-of-hospital cardiac arrest subgroup. Meta-analyses were performed by using STATA 11.0 software. Results: Eight studies involving 29,989 patients were eligible. Overall meta-analysis showed that DACPR was associated with statistically improved rates of BCPR (Odds Ratio [OR], 4.136 [95% confidence interval, 3.741-4.531]), and survival to discharge/ 1-month survival (OR, 1.185 [95% confidence interval, 1.089-1.281]) when compared with no BCPR and Odds Ratio [OR], 1.124 [95% confidence interval, 0.9792-1.456] when compared to independent BCPR. Conclusion: This study found that DACPR resulted in greater survival rate as compared to independent BCPR and no BCPR in OHCAs. Considering that DACPR also resulted in significantly higher rates of BCPR, DACPR should be a standard protocol for EMS systems worldwide.