RT Journal Article SR Electronic T1 Comorbidity and bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 1087 OP 1093 DO 10.1136/heartjnl-2019-315954 VO 106 IS 14 A1 Geir Hirlekar A1 Martin Jonsson A1 Thomas Karlsson A1 Maria Bäck A1 Araz Rawshani A1 Jacob Hollenberg A1 Per Albertsson A1 Johan Herlitz YR 2020 UL http://heart.bmj.com/content/106/14/1087.abstract AB ​Objective Cardiopulmonary resuscitation (CPR) performed before the arrival of emergency medical services (EMS) is associated with increased survival after out-of-hospital cardiac arrest (OHCA). The aim of this study was to determine whether patients who receive bystander CPR have a different comorbidity compared with patients who do not, and to determine the association between bystander CPR and 30-day survival when adjusting for such a possible difference.​Methods Patients with witnessed OHCA in the Swedish Registry for Cardiopulmonary Resuscitation between 2011 and 2015 were included, and merged with the National Patient Registry. The Charlson Comorbidity Index (CCI) was used to measure comorbidity. Multiple logistic regression was used to examine the effect of CCI on the association between bystander CPR and outcome.​Results In total, 11 955 patients with OHCA were included, 71% of whom received bystander CPR. Patients who received bystander CPR had somewhat lower comorbidity (CCI) than those who did not (mean±SD: 2.2±2.3 vs 2.5±2.4; p<0.0001). However, this difference in comorbidity had no influence on the association between bystander CPR and 30-day survival in a multivariable model including other possible confounders (OR 2.34 (95% CI 2.01 to 2.74) without adjustment for CCI and OR 2.32 (95% CI 1.98 to 2.71) with adjustment for CCI).​Conclusion Patients who undergo CPR before the arrival of EMS have a somewhat lower degree of comorbidity than those who do not. Taking this difference into account, bystander CPR is still associated with a marked increase in 30-day survival after OHCA.