Impact of bystander intervention on clinical outcome in out-of-hospital cardiac arrest. A study of 8,253 Polish cases from the European Registry of Cardiac Arrest (2014-2022)

INTRODUCTIONOut-of-hospital cardiac arrest (OHCA) remains a significant public health challenge. This study aimed to assess impact of bystander and dispatcher interventions on survival outcomes in OHCA cases in Poland using data from the European Registry of Cardiac Arrest (EuReCa). MATERIAL AND METHODSA retrospective analysis was conducted on 8,253 patients included in the EuReCa between 2014 and 2022. The data was collected from emergency medical team reports, and survival outcomes at 30 days were obtained from the national death registry. RESULTSA gradual increase in CPR attempted by EMS or bystander, as well as CPR performed with the support of a dispatcher, was observed throughout consecutive years. Dispatcher-guided resuscitation was linked with increased return of spontaneous circulation (ROSC) (22.1% vs 30.6%; P =0.01). Patients treated with implementation of telephone-assisted cardiopulmonary resuscitation were associated with a higher prevalence of ROSC (21.0% vs. 27.4%; P =0.01). CONCLUSIONSDispatcher and bystander interventions significantly improve immediate outcomes in OHCA. However, long-term survival seems to not be improved. System-level strategies to increase AED accessibility, implement real-time support, and standardize Utstein-based reporting in Poland are crucial to increase survival and enable international comparisons.