{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:50:17Z","timestamp":1792587017573,"version":"4.5.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Prompt initiation of bystander cardiopulmonary resuscitation (CPR) is critical to survival for out-of-hospital cardiac arrest (OHCA). However, the association between delays in bystander CPR and OHCA survival is poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>In this observational study using a nationally representative US registry, we identified patients who received bystander CPR from a layperson for a witnessed OHCA from 2013 to 2021. Hierarchical logistic regression was used to estimate the association between time to CPR (&lt;1 minute versus 2\u20133, 4\u20135, 6\u20137, 8\u20139, and \u226510-minute intervals) and survival to hospital discharge and favorable neurological survival (survival to discharge with cerebral performance category of 1 or 2 [ie, without severe neurological disability]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Of 78\u2009048 patients with a witnessed OHCA treated with bystander CPR, the mean age was 63.5\u00b115.7 years and 25, 197 (32.3%) were women. The median time to bystander CPR was 2 (1\u20135) minutes, with 10% of patients having a\u226510-minute delay before initiation of CPR. Overall, 15\u2009000 (19.2%) patients survived to hospital discharge and 13\u2009159 (16.9%) had favorable neurological survival. There was a graded inverse relationship between time to bystander CPR and survival to hospital discharge (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      for trend &lt;0.001). Compared with patients who received CPR within 1 minute, those with a time to CPR of 2 to 3 minutes were 9% less likely to survive to discharge (adjusted odds ratio, 0.91 [95% CI, 0.87\u20130.95]) and those with a time to CPR 4 to 5 minutes were 27% less likely to survive (adjusted odds ratio, 0.73 [95% CI, 0.68\u20130.77]). A similar graded inverse relationship was found between time to bystander CPR and favorable neurological survival (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      for trend &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Among patients with witnessed OHCA, there was a dose-response relationship between delays in bystander initiation of CPR and lower survival rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circoutcomes.123.010116","type":"journal-article","created":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T05:00:13Z","timestamp":1703566813000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":52,"title":["Association Between Delays in Time to Bystander CPR and Survival for Witnessed Cardiac Arrest in the United States"],"prefix":"10.1161","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7025-4442","authenticated-orcid":true,"given":"Dan D.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute, Kansas City, MO (D.D.N., J.A.S., K.F.K., A.I.U., P.S.C.)."},{"name":"University of Missouri-Kansas City (D.D.N., J.A.S., K.G., A.I.U., P.S.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2839-2611","authenticated-orcid":true,"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute, Kansas City, MO (D.D.N., J.A.S., K.F.K., A.I.U., P.S.C.)."},{"name":"University of Missouri-Kansas City (D.D.N., J.A.S., K.G., A.I.U., P.S.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin F.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute, Kansas City, MO (D.D.N., J.A.S., K.F.K., A.I.U., P.S.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kashvi","family":"Gupta","sequence":"additional","affiliation":[{"name":"University of Missouri-Kansas City (D.D.N., J.A.S., K.G., A.I.U., P.S.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anezi I.","family":"Uzendu","sequence":"additional","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute, Kansas City, MO (D.D.N., J.A.S., K.F.K., A.I.U., P.S.C.)."},{"name":"University of Missouri-Kansas City (D.D.N., J.A.S., K.G., A.I.U., P.S.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan F.","family":"McNally","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA (B.F.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5185-3367","authenticated-orcid":true,"given":"Paul S.","family":"Chan","sequence":"additional","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute, Kansas City, MO (D.D.N., J.A.S., K.F.K., A.I.U., P.S.C.)."},{"name":"University of Missouri-Kansas City (D.D.N., J.A.S., K.G., A.I.U., P.S.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000916"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040325"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1405796"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.109.889576"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.304495"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2022.09.016"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.009711"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-6757(85)90032-4"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0196-0644(05)81302-2"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0735-1097(86)80332-1"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.96.10.3308"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.115.001864"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2007.05.005"},{"key":"e_1_3_3_15_2","first-page":"1","article-title":"Out-of-hospital cardiac arrest surveillance \u2014 cardiac arrest registry to enhance survival (CARES), United States, October 1, 2005\u2013December 31, 2010.","volume":"60","author":"McNally B","year":"2011","unstructured":"McNally, B, Robb, R, Mehta, M, Vellano, K, Valderrama, AL, Yoon, PW, Sasson, C, Crouch, A, Perez, AB, Merritt, R, et al. 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