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Comparison 1 Out‐of‐hospital cardiac arrests, Outcome 1 Immediate mortality.
Figures and Tables -
Analysis 1.1

Comparison 1 Out‐of‐hospital cardiac arrests, Outcome 1 Immediate mortality.

Comparison 1 Out‐of‐hospital cardiac arrests, Outcome 2 Mortality at hospital discharge.
Figures and Tables -
Analysis 1.2

Comparison 1 Out‐of‐hospital cardiac arrests, Outcome 2 Mortality at hospital discharge.

Comparison 1 Out‐of‐hospital cardiac arrests, Outcome 3 Neurological impairment in survivors.
Figures and Tables -
Analysis 1.3

Comparison 1 Out‐of‐hospital cardiac arrests, Outcome 3 Neurological impairment in survivors.

Comparison 1 Out‐of‐hospital cardiac arrests, Outcome 4 Complications.
Figures and Tables -
Analysis 1.4

Comparison 1 Out‐of‐hospital cardiac arrests, Outcome 4 Complications.

Comparison 2 In‐hospital cardiac arrests, Outcome 1 Immediate mortality.
Figures and Tables -
Analysis 2.1

Comparison 2 In‐hospital cardiac arrests, Outcome 1 Immediate mortality.

Comparison 2 In‐hospital cardiac arrests, Outcome 2 Mortality at hospital discharge.
Figures and Tables -
Analysis 2.2

Comparison 2 In‐hospital cardiac arrests, Outcome 2 Mortality at hospital discharge.

Comparison 2 In‐hospital cardiac arrests, Outcome 3 Neurological impairment in survivors.
Figures and Tables -
Analysis 2.3

Comparison 2 In‐hospital cardiac arrests, Outcome 3 Neurological impairment in survivors.

Comparison 2 In‐hospital cardiac arrests, Outcome 4 Complications.
Figures and Tables -
Analysis 2.4

Comparison 2 In‐hospital cardiac arrests, Outcome 4 Complications.

Comparison 3 Subgroup analysis: Physician in first responding team or only paramedics, Outcome 1 Immediate mortality.
Figures and Tables -
Analysis 3.1

Comparison 3 Subgroup analysis: Physician in first responding team or only paramedics, Outcome 1 Immediate mortality.

Comparison 3 Subgroup analysis: Physician in first responding team or only paramedics, Outcome 2 Mortality at hospital discharge.
Figures and Tables -
Analysis 3.2

Comparison 3 Subgroup analysis: Physician in first responding team or only paramedics, Outcome 2 Mortality at hospital discharge.

Comparison 3 Subgroup analysis: Physician in first responding team or only paramedics, Outcome 3 Neurological impairment in survivors (any severity).
Figures and Tables -
Analysis 3.3

Comparison 3 Subgroup analysis: Physician in first responding team or only paramedics, Outcome 3 Neurological impairment in survivors (any severity).

Comparison 4 Sensitivity analysis: Best quality studies, Outcome 1 Immediate mortality.
Figures and Tables -
Analysis 4.1

Comparison 4 Sensitivity analysis: Best quality studies, Outcome 1 Immediate mortality.

Comparison 4 Sensitivity analysis: Best quality studies, Outcome 2 Mortality at hospital discharge.
Figures and Tables -
Analysis 4.2

Comparison 4 Sensitivity analysis: Best quality studies, Outcome 2 Mortality at hospital discharge.

Comparison 4 Sensitivity analysis: Best quality studies, Outcome 3 Neurological impairment in survivors (any severity).
Figures and Tables -
Analysis 4.3

Comparison 4 Sensitivity analysis: Best quality studies, Outcome 3 Neurological impairment in survivors (any severity).

Comparison 5 Sensitivity analysis: Largest (n > 500) studies, Outcome 1 Immediate mortality.
Figures and Tables -
Analysis 5.1

Comparison 5 Sensitivity analysis: Largest (n > 500) studies, Outcome 1 Immediate mortality.

Comparison 5 Sensitivity analysis: Largest (n > 500) studies, Outcome 2 Mortality at hospital discharge.
Figures and Tables -
Analysis 5.2

Comparison 5 Sensitivity analysis: Largest (n > 500) studies, Outcome 2 Mortality at hospital discharge.

Comparison 5 Sensitivity analysis: Largest (n > 500) studies, Outcome 3 Neurological impairment in survivors (any severity).
Figures and Tables -
Analysis 5.3

Comparison 5 Sensitivity analysis: Largest (n > 500) studies, Outcome 3 Neurological impairment in survivors (any severity).

Comparison 1. Out‐of‐hospital cardiac arrests

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Immediate mortality Show forest plot

10

4162

Risk Ratio (M‐H, Random, 95% CI)

0.98 [0.94, 1.03]

2 Mortality at hospital discharge Show forest plot

9

3412

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.98, 1.01]

3 Neurological impairment in survivors Show forest plot

5

358

Risk Ratio (M‐H, Fixed, 95% CI)

1.74 [1.06, 2.83]

3.1 Moderate neurological impairment

4

107

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.34, 2.79]

3.2 Severe neurological impairment

4

107

Risk Ratio (M‐H, Fixed, 95% CI)

3.11 [0.98, 9.83]

3.3 Any neurological impairment (any severity)

5

144

Risk Ratio (M‐H, Fixed, 95% CI)

1.71 [0.90, 3.25]

4 Complications Show forest plot

7

3032

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.86, 1.38]

Figures and Tables -
Comparison 1. Out‐of‐hospital cardiac arrests
Comparison 2. In‐hospital cardiac arrests

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Immediate mortality Show forest plot

2

826

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.88, 1.08]

2 Mortality at hospital discharge Show forest plot

2

826

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.95, 1.05]

3 Neurological impairment in survivors Show forest plot

2

279

Risk Ratio (M‐H, Fixed, 95% CI)

1.19 [0.63, 2.25]

3.1 Moderate neurologic impairment

2

93

Risk Ratio (M‐H, Fixed, 95% CI)

0.5 [0.10, 2.58]

3.2 Severe neurologic impairment

2

93

Risk Ratio (M‐H, Fixed, 95% CI)

1.95 [0.59, 6.50]

3.3 Any neurological impairment (any severity)

2

93

Risk Ratio (M‐H, Fixed, 95% CI)

1.19 [0.50, 2.86]

4 Complications Show forest plot

1

773

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.49, 1.93]

Figures and Tables -
Comparison 2. In‐hospital cardiac arrests
Comparison 3. Subgroup analysis: Physician in first responding team or only paramedics

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Immediate mortality Show forest plot

10

4162

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.94, 1.01]

1.1 Physician in first responding team

5

1487

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.89, 1.04]

1.2 Only paramedics in first responding team

5

2675

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.95, 1.02]

2 Mortality at hospital discharge Show forest plot

9

3412

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.98, 1.01]

2.1 Physician in first responding team

4

737

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.94, 1.04]

2.2 Only paramedics in first responding team

5

2675

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.98, 1.01]

3 Neurological impairment in survivors (any severity) Show forest plot

5

144

Risk Ratio (M‐H, Fixed, 95% CI)

1.71 [0.90, 3.25]

3.1 Physician in first responding team

2

44

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.41, 2.80]

3.2 Only paramedics in first responding team

3

100

Risk Ratio (M‐H, Fixed, 95% CI)

2.19 [0.93, 5.13]

Figures and Tables -
Comparison 3. Subgroup analysis: Physician in first responding team or only paramedics
Comparison 4. Sensitivity analysis: Best quality studies

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Immediate mortality Show forest plot

12

4988

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.95, 1.01]

1.1 Allocation concealment adequate

5

2460

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.96, 1.06]

1.2 Allocation concealment unclear

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

1.13 [0.77, 1.65]

1.3 Allocation concealment inadequate

6

2467

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.90, 0.99]

2 Mortality at hospital discharge Show forest plot

11

4238

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.98, 1.01]

2.1 Allocation concealment adequate

5

2460

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.97, 1.02]

2.2 Allocation concealment unclear

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.87, 1.25]

2.3 Allocation concealment inadequate

5

1717

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.97, 1.02]

3 Neurological impairment in survivors (any severity) Show forest plot

7

237

Risk Ratio (M‐H, Fixed, 95% CI)

1.50 [0.89, 2.51]

3.1 Allocation concealment adequate

3

163

Risk Ratio (M‐H, Fixed, 95% CI)

1.45 [0.75, 2.79]

3.2 Allocation concealment unclear

1

7

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.33, 2.37]

3.3 Allocation concealment inadequate

3

67

Risk Ratio (M‐H, Fixed, 95% CI)

2.09 [0.67, 6.54]

Figures and Tables -
Comparison 4. Sensitivity analysis: Best quality studies
Comparison 5. Sensitivity analysis: Largest (n > 500) studies

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Immediate mortality Show forest plot

5

3815

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.93, 1.00]

2 Mortality at hospital discharge Show forest plot

4

3065

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.98, 1.02]

3 Neurological impairment in survivors (any severity) Show forest plot

3

159

Risk Ratio (M‐H, Fixed, 95% CI)

1.60 [0.81, 3.16]

Figures and Tables -
Comparison 5. Sensitivity analysis: Largest (n > 500) studies