Estimating the effect of bystander-initiated cardiopulmonary resuscitation in Japan

Miho Sekimoto, Yoshinori Noguchi, Mahbubur Rahman, Kenji Hira, Michihiko Fukui, Keiji Enzan, Hideo Inaba, Tsuguya Fukui

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Low incidence of bystander-initiated cardiopulmonary resuscitation (CPR) is allegedly responsible for poor survival from out-of-hospital cardiac arrest (OHCA) in Japan. This study was conducted to determine significant predictors for survival after collapse-witnessed OHCA of presumed cardiac etiology to investigate the impact of bystander-initiated CPR. Logistic regression analysis of OHCA of presumed cardiac etiology was performed on retrospective data sets from three Japanese suburban communities. All arrest incidents were witnessed and occurred prior to the arrival of EMS personnel. Outcome measure was survival to discharge. Initial electrocardiogram (ECG) rhythm (ventricular fibrillation (VF) or not), interval from collapse to CPR (within 5 min or not), and initial ECG rhythm/collapse-to-CPR interval interaction were significantly associated with survival. Patient age (70 years or less/over 70 years), interval from collapse to EMS response, and bystander-initiated CPR were significantly associated with VF in an initial ECG. The effectiveness of bystander-initiated CPR for OHCA can be successfully predicted based on the interval from collapse to CPR and initial ECG rhythm. The increase in the proportion of bystander-initiated CPR from the present level of 20-50% would be expected to rescue another 1800 victims of OHCA per year in Japan.

Original languageEnglish (US)
Pages (from-to)153-160
Number of pages8
Issue number2
StatePublished - 2001
Externally publishedYes


  • Bystander CPR
  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Out-of-hospital CPR
  • Outcome
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine


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