Correlation Between Cardiopulmonary Resuscitation Duration and Neurological Outcomes Following Out-of-Hospital Cardiac Arrest: A Dose–Response Meta-Analysis

Out-of-hospital cardiac arrest stands as a prominent global public health challenge. The effect of cardiopulmonary resuscitation (CPR) duration on neurological outcomes is inconclusive. Therefore, this study seeks to systematically review the link between CPR duration and neurological outcomes following out-of-hospital cardiac arrest. Web of Science, Cochrane Library, PubMed, and Embase were searched up to October 15, 2024. The quality of the included studies was appraised via the Newcastle-Ottawa Scale. StataMP/15.1 was employed to analyze heterogeneity, sensitivity, and the dose-response relationship. Eight studies involving 369,897 patients were selected. This study unraveled that compared to the shortest CPR duration, prolonged CPR duration was correlated with a lower probability of good neurological outcomes [odds ratio = 0.05, 95% confidence interval: (0.02, 0.16), P < 0.001]. Moreover, prolonged CPR duration was related to a notably reduced 1-month survival rate [odds ratio = 0.06, 95% confidence interval: (0.03, 0.14), P < 0.001]. Dose-response analysis indicated nonlinear correlations between CPR duration and both favorable neurological prognosis and 1-month survival rate (P < 0.001). However, generally, the correlations between them were negative. In conclusion, prolonged CPR duration can substantially reduce the probability of favorable neurological prognosis and 1-month survival rate. Since the number of selected studies was small, high-quality studies are needed to validate the results.