UC San Diego

Background: Bystander cardiopulmonary resuscitation (BCPR) improves the low survival rate in out-of-hospital cardiac arrest (OHCA). We aim to estimate the potential impact of the San Diego County “Revive & Survive” initiative, a community BCPR training program with the goal to train 1 million San Diegans in hands-only CPR.

Methods: We adapted a decision tree model simulating health outcomes among a population with OHCA eligible for BCPR. The model was parameterized with the San Diego County Cardiac Arrest Registry to Enhance Survival (CARES) database from 2020-2023, which receives input from participating large healthcare agencies. Based on a systematic review, we assume community BCPR training increases the proportion of OHCA patients who receive BCPR by 41% and the chances of survival if BCPR is received by 59%. We estimate 5-year impacts on BCPR, deaths, and quality-adjusted life years (QALYs).

Results: Analysis suggests 8,445 (95% CI 7883.7-9006.1) OHCA cases eligible for BCPR will be tracked in CARES from 2024 to 2029. The model forecasts the implementation of Revive & Survive will result in an absolute increase of 1,701 (95% CI 1508.0-1906.0) BCPR events, leading to 467 (95% CI 312.5-648.5) lives and 1,730 (95% CI 1156.0-2403.7) QALYs saved compared to current interventions over five years.

Conclusions: Our model predicts that implementation of Revive & Survive will result in substantial increases in the number of OHCA patients in our population receiving BCPR, leading to increased survival rates in a large population. Additional benefits not examined include impacts on other populations, such as those not captured in CARES and organ transplant recipients.