Similar Cardiac and Neurological Outcomes of Chest Compression-Only Versus Standard CPR but lower survival with CPR after sensitivity analysis. : A Meta-analysis of Randomized Controlled Trials and Observational Cohorts in Out-of-Hospital Cardiac Arrest (OHCA)
Bibliographic record
Abstract
Abstract Background Out-of-hospital cardiac arrest (OHCA) has high mortality, and bystander cardiopulmonary resuscitation (CPR) improves outcomes. The effectiveness of chest compression-only CPR (CCO) versus standard CPR (sCPR) with ventilation remains unclear. This meta-analysis assesses their impact on survival, neurological recovery, and return of spontaneous circulation (ROSC). Methods A systematic review and meta-analysis followed PRISMA guidelines. PubMed, Scopus, Web of Science, Embase, Google Scholar, and Cochrane Library were searched. Eligible studies included RCTs and observational studies on adult OHCA. Pediatric and non-original studies were excluded. Primary outcomes were survival to hospital discharge (SHD) and neurological recovery, while secondary outcomes included ROSC, survival to hospital admission, and 24-hour and one-month survival. Study quality was assessed using ROB-2 for RCTs and the Newcastle-Ottawa Scale (NOS) for observational studies. A random-effects model was applied, and publication bias was evaluated. Results A total of 18 studies (5 RCTs, 13 observational) with 232,655 OHCA cases were analyzed. SHD rates showed no significant difference (OR = 0.85, 95% CI: 0.61–1.19, P = 0.29). Favorable neurological outcomes were similar (OR = 0.87, 95% CI: 0.64–1.20, P = 0.32). Prehospital ROSC rates were comparable (OR = 1.06, 95% CI: 0.89–1.27, P = 0.43). No difference was found in survival to hospital admission (OR = 1.12, 95% CI: 0.53– 2.29, P = 0.34). For 24-hour mortality, no difference was found (OR = 0.92, 95% CI: 0.83–1.01, P = 0.07), but sCPR had lower survival after sensitivity analysis (OR = 0.90, 95% CI: 0.82–1.00, P = 0.04). One-month mortality was similar (OR = 1.26, 95% CI: 0.98–1.62, P = 0.07), but sCPR had a higher risk after outlier removal (OR = 1.32, 95% CI: 1.02–1.71, P = 0.03). Hospital discharge rates showed no difference (OR = 0.79, 95% CI: 0.36–1.72, P = 0.55). SHD with favorable neurological outcomes did not differ significantly (OR = 1.47, 95% CI: 0.09–22.68, P = 0.61). Subgroup analyses indicated sCPR benefits in witnessed arrests and shockable rhythms. Conclusion No significant differences were found between CCO and sCPR in key survival outcomes. While sCPR may benefit specific subgroups, CCO remains an effective alternative that increases bystander participation. Further research is needed to refine guidelines
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.032 | 0.064 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.017 | 0.077 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".