Paramedic PapersHome Cardiac arrest Bystander CPR up but outcomes flat in the very old
Cardiac arrest
Bystander CPR up but outcomes flat in the very old
Temporal trends in bystander cardiopulmonary resuscitation and favourable neurological outcome among older patients with out-of-hospital cardiac arrest stratified by bystander–patient relationship and age: A JCS-ReSS Study
Resuscitation Plus · 2026-10 · Added 9 October 2026
Analysis of 322,943 bystander-witnessed OHCA patients aged ≥65 in the All-Japan Utstein Registry (2005–22) found bystander CPR rose over time but stalled near 50%, and 1-month favourable neurological outcome stayed around 1% in those aged ≥90 despite CPR rates near 80%.
- Study type
- Registry
- Design
- National registry cohort with temporal trend analysis
- Participants
- 322,943 people aged ≥65 with bystander-witnessed cardiac OHCA
- Main finding
- Bystander CPR increased significantly in all age and bystander-relationship strata (all p<0.001) but remained ~50% in family-witnessed arrests; CPC 1–2 at 1 month improved only in the 65–74 group with non-family bystanders; in those ≥90 bystander CPR reached ~80% while CPC 1–2 stayed flat at ~1%
- Caveat
- Observational secular trends from a single national registry — no causal inference, and bystander behaviour and health-system differences may limit generalisability
- Bottom line
- Context only
Why it matters in Australia (High relevance). Bystander-witnessed arrest in older patients is the bread and butter of OHCA everywhere, and community CPR uptake is a national priority — a 320,000-patient registry makes these trends hard to wave away.
Learning goal
Recognise how age and bystander relationship shape realistic outcomes and resuscitation decisions in older cardiac arrest patients.
More
- Topic: Cardiac arrest
- Daily scan: 9 October 2026
- Podcast: Paramedic Papers Daily, 9 October 2026
Related papers on Cardiac arrest
-
CPR injuries common after long arrests
A single-centre retrospective cohort of 136 OHCA patients found CPR-related injuries in 43% (16.9% clinically significant), with CPR duration over 20 minutes — not ECPR or mechanical CPR — independently associated with injury (OR 2.45).
-
Long resuscitations don't rule out good recovery
Danish national registry study of bystander-witnessed OHCA survivors asking whether longer time-to-ROSC means worse long-term outcomes — anoxic brain damage rose with time, but long-term survival, return to work and nursing-home admission did not, showing prolonged resuscitation doesn't preclude good recovery.
-
TANGO2: compression-only vs standard bystander CPR
Protocol for TANGO2, a Swedish-Italian dispatcher-randomised non-inferiority trial testing whether bystander compression-only CPR is non-inferior to standard CPR for 30-day survival in ~3,260 dispatch-assisted OHCA patients.
-
Bystander AEDs work — when someone actually grabs one
Korean multicentre OHCA registry analysis estimating bystander AED effectiveness against a no-defibrillation reference — AED application was associated with outcomes comparable to or better than EMS shocks, but was applied in only a fraction of eligible cases, especially at home.