Revive & survive San Diego: modeling the potential impact of a community bystander CPR training initiative

Abstract Background Out-of-hospital cardiac arrests (OHCA) remain a significant public health concern, with high incidence and mortality rates. Bystander cardiopulmonary resuscitation (BCPR) can significantly improve survival and neurological outcomes. We aim to estimate the potential impact of “Revive & Survive San Diego”, a community BCPR training program initiated in 2024 with the goal to train 1 million San Diegans in hands-only BCPR by 2026. Methods We adapt a decision tree model simulating health outcomes among a population with OHCA eligible for BCPR. We parameterize the model with data from the 2020–2023 San Diego County Cardiac Arrest Registry to Enhance Survival (CARES) database. We estimate 5-year impacts on BCPR, deaths, life-years, and quality-adjusted life-years (QALYs) with a multivariate probabilistic uncertainty analysis. Results Modeling suggests 8,445 (95% uncertainty interval (UI) 7884–9006) OHCA cases eligible for BCPR will be tracked in CARES within the 5-year period after achieving the goal of 1 million residents trained. Among these individuals, the initiative could result in an increase of 1,643 (95% UI 1113–2231) BCPR events, leading to 399 (95% UI 164–740) lives saved and 1,477 (95% UI 613–2739) QALYs saved compared to maintaining the status quo over five years. Conclusions The “Revive & Survive San Diego” initiative could substantially improve OHCA outcomes in San Diego County. Future research should assess the observed impact, focus on tailoring interventions to promote health equity across diverse populations, and explore secondary benefits like increased organ donation.