American Heart Association

American Heart Association

November 12, 2018
2 min read

CPR education laws increase survival rates in out-of-hospital cardiac arrest

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Victoria Vetter
Victoria Vetter

CHICAGO — States with CPR high school education laws had higher rates of bystander CPR, survival to hospital discharge and neurologically favorable survival after out-of-hospital cardiac arrest, according to an abstract presented at the American Heart Association Scientific Sessions.

“All health providers and citizens should advocate for CPR/AED education, public AED placement and pay attention to factors in the personal and family history that can increase the risk of sudden cardiac death,” Victoria Vetter, MD, MPH, professor of pediatrics at the Children’s Hospital of Philadelphia, told Cardiology Today.

Researchers analyzed data from 109,668 patients (64% men) from the CARES database who had nontraumatic out-of-hospital cardiac arrest from 2013 to 2017.

Outcomes of interest were survival to hospital discharge, bystander CPR and neurologically favorable survival, defined as a Cerebral Performance Category score of 1 or 2 at discharge.

The majority of out-of-hospital cardiac arrests occurred at home (81.8%), and 44.3% were in the presence of bystanders. States with CPR high school education laws had 59% of events included in the study.

A higher percent of out-of-hospital cardiac arrests received bystander CPR prior to emergency medical services arrival in states with CPR high school education law enacted compared with states without laws (41.3% vs. 36.1%; P < .001).

Bystander CPR was less common in women (37.6% vs. 40.1% in men), those older than 50 years (38.7% vs. 40.6% for younger than 50 years), black and Hispanic patients (25.6% and 31.8%, respectively, vs. 42.3% for whites; P < .001 for all). Overall survival to hospital discharge was 10.3%, and 8.7% had a favorable neurological outcome. A higher percent survived to hospital discharge in states with CPR high school education laws compared with states without laws (11.3% vs. 8.9%; P < .001). Neurologically favorable survival was more likely in states with CPR high school education laws enacted compared with states without laws (9.5% vs. 7.6%).

A favorable neurological outcome occurred in 8.8% of patients, and 10.4% survived to hospital discharge.

“With regard to further research, we are evaluating the impact of these laws on indicators of lower socioeconomic status,” Vetter said in an interview. – by Darlene Dobkowski


Vetter V, et al. Presentation 22. Presented at: American Heart Association Scientific Sessions; Nov. 10-12, 2018; Chicago.

Disclosure: Vetter reports no relevant financial disclosures.