Purpose: Telephone CPR (cardiopulmonary resuscitation) is one of the topics to improve outcome for OHCA (out-of-hospital cardiac arrest) patients. Kumamoto city has about 700,000 population. From 2012, Kumamoto city started telephone CPR protocol, and with or without telephone CPR were reflected in each prehospital record. In the present study, we assessed the telephone CPR had impact to improve neurological outcome or not, by multivariate analysis. 
Methods: Prehospital records of OHCA were retrospectively analyzed. Patients were divided into two groups with and without telephone CPR protocol. Comparison of favorable neurological outcome (CPC 1-2 at 28th day) was performed by univariate analysis and propensity score analysis (IPTW: inverse probability of treatment weighted method). 
Results: 1607 cases of OHCA records (2013-2015) were analyzed. Telephone CPR increase bystander cardiopulmonary resuscitation (BCPR) and public access defibrillation (PAD) (BCPR: 72% v.s. 17%, P<0.001, PAD: 11% v.s. 5%, P<0.001, with v.s. without telephone CPR, respectively). The cases with telephone CPR showed more favorable neurological outcome than the cases without telephone CPR by propensity score analysis (odds ratio: 1.718[1.017-2.902], P = 0.043). 
Conclusions: Telephone CPR increased prehospital BCPR and PAD, and also improved the neurological outcome in Kumamoto city.

Telephone CPR Could Improve Patients Neurological Outcome from Analysis of 3 years Kumamoto City Prehospital Record of Out-of-hospital Cardiac Arrest.