BACKGROUND: Survival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR). METHOD: In this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed. RESULTS: A total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17-1.83). CONCLUSION: In this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both.

Department of Anaesthesiology and Intensive Care Medicine University Hospital of Cologne Germany; European Resuscitation Council Niel Belgium

Department of Cardiology Amsterdam UMC Location Academic Medical Center Amsterdam The Netherlands

Department of Emergency Medicine and Services University of Helsinki and Helsinki University Hospital Helsinki Finland

Emergency Medical Services of the Hradec Králové Region Hradec Králové Czech Republic; Department of Anaesthesiology and Intensive Care Medicine Charles University Prague Faculty of Medicine Hradec Králové University Hospital Hradec Králové Czech Republic

Hungarian Resuscitation Council

Institute for Research in Operative Medicine Faculty of Health University Witten Herdecke Cologne Germany

Jagiellonian University Medical College Department of Medical Education Poland

Medical Intensive Care Unit University Medical Centre Maribor Maribor Slovenia; Slovenian Resuscitation Council Slovenian Society for Emergency Medicine Ljubljana Slovenia

Medical University of Innsbruck Department of Anaesthesia and Intensive Care Innsbruck Austria

National Ambulance Service and National University of Ireland Galway Ireland

P J Safarik University Medical Faculty L Pasteur University Hospital Department of Anaesthesiology and Intensive Medicine Kosice Slovakia

Prehospen Centre for Prehospital Research Faculty of Caring Science Work Life and Social Welfare University of Borås Borås Sweden

School of Education Health and Social Studies Dalarna University S 79188 Falun Sweden; Centre for Clinical Research Dalarna Uppsala University S 79182 Falun Sweden; Department of Prehospital Care Region of Dalarna S 79129 Falun Sweden

Serbian Resuscitation Council Novi Sad Serbia; European University Cyprus School of Medicine Nicosia Cyprus

Service des Urgences et du SMUR Centre Hospitalier Universitaire Saint Pierre Université Libre de Bruxelles Belgium

Servicio de Urgencias y Emergencias 061 de La Rioja Spain

Univ Lille CHU Lille ULR 2694 METRICS Évaluation des Technologies de Santé et des Pratiques Médicales F 59000 Lille France

University Hospital Dubrava Zagreb Faculty of Dental Medicine and Health Josip Juraj Strossmayer University Osijek Croatia

University Hospital Schleswig Holstein Department of Anaesthesiology and Intensive Care Medicine Lübeck Germany

University Hospital Schleswig Holstein Institute for Emergency Medicine Kiel Germany; Division of Prehospital Services Oslo University Hospital Norway; Faculty of Medicine Institute of Clinical Medicine University of Oslo Norway

University Hospital Schleswig Holstein Institute for Emergency Medicine Kiel Germany; University Hospital Schleswig Holstein Department of Anaesthesiology and Intensive Care Medicine Kiel Germany; European Resuscitation Council Niel Belgium

University Hospital Schleswig Holstein Institute for Emergency Medicine Kiel Germany; University Hospital Schleswig Holstein Department of Anaesthesiology and Intensive Care Medicine Kiel Germany; University of Namibia School of Medicine Windhoek Namibia

University of Antwerp Antwerp Belgium; European Resuscitation Council Niel Belgium

Warwick Clinical Trials Unit Warwick Medical School University of Warwick Coventry United Kingdom; University Hospitals Birmingham NHS Foundation Trust Birmingham United Kingdom; European Resuscitation Council Niel Belgium

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