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Resuscitation. 2014 Jan;85(1):53-8. doi: 10.1016/j.resuscitation.2013.07.033. Epub 2013 Sep 19.

Bystander-initiated CPR in an Asian metropolitan: does the socioeconomic status matter?

Author information

1
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine College of Public Health, National Taiwan University, Taipei, Taiwan.
2
Department of Emergency Medicine, Oregon Health and Science University, Portland, OR, United States.
3
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
4
Taipei City Fire Department, Taiwan.
5
Department of Health, Taipei City Government, Taiwan.
6
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Health, Taipei City Government, Taiwan.
7
Taipei City Hospital, Chung-Shaw Branch, Taiwan.
8
Graduate Institute of Epidemiology and Preventive Medicine College of Public Health, National Taiwan University, Taipei, Taiwan.
9
Graduate Institute of Epidemiology and Preventive Medicine College of Public Health, National Taiwan University, Taipei, Taiwan. Electronic address: mslai@ntu.edu.tw.
10
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: mattma.tw@gmail.com.

Abstract

OBJECTIVES:

To determine the association of neighborhood socioeconomic status (SES) with bystander-initiated cardiopulmonary resuscitation (CPR) and patient outcomes of out of hospital cardiac arrests (OHCAs) in an Asian metropolitan area.

METHODS:

We performed a retrospective study in a prospectively collected cohort from the Utstein registry of adult non-traumatic OHCAs in Taipei, Taiwan. Average real estate value was assessed as the first proxy of SES. Twelve administrative districts in Taipei City were categorized into low versus high SES areas to test the association. The primary outcome was bystander-initiated CPR, and the secondary outcome was patient survival status. Factors associated with bystander-initiated CPR were adjusted for in multivariate analysis. The mean household income was assessed as the second proxy of SES to validate the association.

RESULTS:

From January 1, 2008 to December 30, 2009, 3573 OHCAs received prehospital resuscitation in the community. Among these, 617 (17.3%) cases received bystander CPR. The proportion of bystander CPR in low-SES vs. high-SES areas was 14.5% vs. 19.6% (p<0.01). Odds ratio of receiving bystander-initiated CPR in low-SES areas was 0.72 (95% confidence interval: [0.60-0.88]) after adjusting for age, gender, witnessed status, public collapse, and OHCA unrecognized by the online dispatcher. Survival to discharge rate was significantly lower in low-SES areas vs. high-SES areas (4.3% vs. 6.8%; p<0.01). All results above remained consistent in the analyses by mean household income.

CONCLUSIONS:

Patients who experienced an OHCA in low-SES areas were less likely to receive bystander-initiated CPR, and demonstrated worse survival outcomes.

KEYWORDS:

Cardiopulmonary resuscitation (CPR); Education; Emergency medical system (EMS); First responder; Neighborhood; Socioeconomic status (SES)

[Indexed for MEDLINE]
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