Mobile phone technologies to alert citizen first responders to out-of-hospital cardiac arrests (OHCAs) were implemented in numerous countries. This systematic review and meta-analysis aim to investigate whether activating citizen first responders increases bystanders' interventions and improves outcomes. We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials from inception to 24 November 2021, for studies comparing citizen first responders' activation versus standard emergency response in the case of OHCA. The primary outcome was survival at hospital discharge or 30 days. Secondary outcomes were discharge with favourable neurological outcome, bystander-initiated cardiopulmonary resuscitation (CPR), and the use of automated external defibrillators (AEDs) before ambulance arrival. Evidence certainty was evaluated with GRADE. Our search strategy yielded 1215 articles. After screening, we included 10 studies for a total of 23 351 patients. OHCAs for which citizen first responders were activated had higher rates of survival at hospital discharge or 30 days compared with standard emergency response [nine studies; 903/9978 (9.1%) vs. 1104/13 247 (8.3%); odds ratio (OR), 1.45; 95% confidence interval (CI), 1.21-1.74; P < 0.001], return of spontaneous circulation [nine studies; 2575/9169 (28%) vs. 3445/12 607 (27%); OR, 1.40; 95% CI, 1.07-1.81; P = 0.01], bystander-initiated CPR [eight studies; 5876/9074 (65%) vs. 6384/11 970 (53%); OR, 1.75; 95% CI, 1.43-2.15; P < 0.001], and AED use [eight studies; 654/9132 (7.2%) vs. 624/14 848 (4.2%); OR, 1.82; 95% CI, 1.31-2.53; P < 0.001], but similar rates of neurological intact discharge [three studies; 316/2685 (12%) vs. 276/2972 (9.3%); OR, 1.37; 95% CI, 0.81-2.33; P = 0.24]. Alerting citizen first responders to OHCA patients is associated with higher rates of bystander-initiated CPR, use of AED before ambulance arrival, and survival at hospital discharge or 30 days.

中文翻译：

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派遣公民作为院外心脏骤停的第一反应者：系统评价和荟萃分析。

许多国家都采用了移动电话技术，用于向公民急救人员发出院外心脏骤停 (OHCA) 警报。这项系统回顾和荟萃分析旨在调查激活公民急救人员是否会增加旁观者的干预并改善结果。我们检索了 PubMed、EMBASE 和 Cochrane 对照试验中央注册库，从开始到 2021 年 11 月 24 日，以比较 OHCA 情况下公民急救人员的激活与标准应急响应的研究。主要结局是出院时或 30 天的生存率。次要结局是出院时神经功能良好、旁观者发起心肺复苏 (CPR) 以及在救护车到达前使用自动体外除颤器 (AED)。证据的确定性通过 GRADE 进行评估。我们的搜索策略产生了 1215 篇文章。经过筛选后，我们纳入了 10 项研究，总共涉及 23 351 名患者。与标准紧急响应相比，激活公民急救人员的 OHCA 出院时或 30 天的存活率更高[九项研究；903/9978 (9.1%) 对比 1104/13 247 (8.3%)；优势比（OR），1.45；95%置信区间（CI），1.21-1.74；P < 0.001]，自主循环恢复[九项研究；2575/9169 (28%) 对比 3445/12 607 (27%)；或，1.40；95% CI，1.07-1.81；P = 0.01]，旁观者发起的心肺复苏[八项研究；5876/9074 (65%) 对比 6384/11 970 (53%)；或，1.75；95% CI，1.43-2.15；P < 0.001] 和 AED 使用 [八项研究；654/9132 (7.2%) 对比 624/14 848 (4.2%)；或，1.82；95% CI，1.31-2.53；P < 0.001]，但神经系统完整放电率相似[三项研究；316/2685 (12%) 对比 276/2972 (9.3%)；或，1.37；95% CI，0.81-2.33；P = 0.24]。提醒公民急救人员注意 OHCA 患者与旁观者发起的心肺复苏、救护车到达前使用 AED 以及出院时或 30 天的存活率较高相关。