Effect of Bystander CPR on Survival After Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis
Abstract
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a leading cause of death globally. The timely initiation of bystander cardiopulmonary resuscitation (CPR) is considered a critical determinant of survival.
OBJECTIVE: To evaluate the association of bystander CPR with survival after OHCA.
METHODS: We conducted a systematic review and meta-analysis, searching PubMed, EMBASE, Web of Science, and Scopus through July 31, 2025. We included observational studies that compared survival outcomes between OHCA patients who received bystander CPR and those who did not. The primary outcomes assessed were survival to hospital admission, survival to hospital discharge, and 30-day survival. A random-effects model was used to pool adjusted odds ratios (ORs). Potential sources of heterogeneity were examined using subgroup analyses and meta-regressions. Risk of bias was evaluated using Risk Of Bias In Nonrandomized Studies of Interventions.
RESULTS: Our analysis included 72 studies, comprising 2,914,595 OHCA events. The pooled analysis showed a 26% increase in odds of survival to hospital admission [12 studies; OR, 1.26; 95% confidence interval (CI), 1.09-1.46; I 2 = 77.9%]. The benefit was more pronounced for survival to hospital discharge, with a 44% increase in odds (43 studies; OR, 1.44; 95% CI, 1.33-1.56; I 2 = 83.8%), and was greatest for 30-day survival, with a 50% increase in odds (23 studies; OR, 1.50; 95% CI, 1.34-1.67; I 2 = 95.6%). The survival benefit varied significantly by…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Understanding the factors influencing fall armyworm (Spodoptera frugiperda J.E. Smith) damage in African smallholder maize fields and quantifying its impact on yield. A case study in Eastern Zimbabwe
- Alarming situation of emerging H5 and H7 avian influenza and effective control strategies
- Livestock and food security: vulnerability to population growth and climate change
- Atmosphere–ocean oxygen and productivity dynamics during early animal radiations
- Characterization of the global distribution and diversified plasmid reservoirs of the colistin resistance gene mcr-9
- The global seroprevalence of Toxoplasma gondii in pigs: A systematic review and meta-analysis
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.