Regions of High Out-Of-Hospital Cardiac Arrest Incidence and Low Bystander CPR Rates in Victoria, Australia

Lahn D Straney; Janet E Bray; Ben Beck; Judith Finn; Stephen Bernard; Kylie Dyson; Marijana Lijovic; Karen Smith

doi:10.1371/journal.pone.0139776

Regions of High Out-Of-Hospital Cardiac Arrest Incidence and Low Bystander CPR Rates in Victoria, Australia

PLoS One. 2015 Oct 8;10(10):e0139776. doi: 10.1371/journal.pone.0139776. eCollection 2015.

Authors

Lahn D Straney¹, Janet E Bray², Ben Beck¹, Judith Finn³, Stephen Bernard⁴, Kylie Dyson⁵, Marijana Lijovic⁶, Karen Smith⁵

Affiliations

¹ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
² Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Faculty of Health Science, Curtin University, Perth, Western Australia, Australia.
³ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Faculty of Health Science, Curtin University, Perth, Western Australia, Australia; St John Ambulance Western Australia, Perth, Western Australia, Australia.
⁴ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Intensive Care Unit, The Alfred Hospital Melbourne, Victoria, Australia.
⁵ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia.
⁶ Ambulance Victoria, Melbourne, Victoria, Australia.

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) remains a major public health issue and research has shown that large regional variation in outcomes exists. Of the interventions associated with survival, the provision of bystander CPR is one of the most important modifiable factors. The aim of this study is to identify census areas with high incidence of OHCA and low rates of bystander CPR in Victoria, Australia.

Methods: We conducted an observational study using prospectively collected population-based OHCA data from the state of Victoria in Australia. Using ArcGIS (ArcMap 10.0), we linked the location of the arrest using the dispatch coordinates (longitude and latitude) to Victorian Local Government Areas (LGAs). We used Bayesian hierarchical models with random effects on each LGA to provide shrunken estimates of the rates of bystander CPR and the incidence rates.

Results: Over the study period there were 31,019 adult OHCA attended, of which 21,436 (69.1%) cases were of presumed cardiac etiology. Significant variation in the incidence of OHCA among LGAs was observed. There was a 3 fold difference in the incidence rate between the lowest and highest LGAs, ranging from 38.5 to 115.1 cases per 100,000 person-years. The overall rate of bystander CPR for bystander witnessed OHCAs was 62.4%, with the rate increasing from 56.4% in 2008-2010 to 68.6% in 2010-2013. There was a 25.1% absolute difference in bystander CPR rates between the highest and lowest LGAs.

Conclusion: Significant regional variation in OHCA incidence and bystander CPR rates exists throughout Victoria. Regions with high incidence and low bystander CPR participation can be identified and would make suitable targets for interventions to improve CPR participation rates.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia / epidemiology
Bayes Theorem
Cardiopulmonary Resuscitation*
Databases, Factual
Emergency Medical Services
Humans
Incidence
Out-of-Hospital Cardiac Arrest / epidemiology*
Prospective Studies
Registries

Grants and funding

LS, BB, JB and JF receive salary support from the NHMRC Australian Resuscitation Outcomes Consortium (Aus-ROC) Centre of Research Excellence (CRE) (ID:1029983, https://www.ausroc.org.au). KD is supported by a National Health and Medical Research Council (NHMRC) Public Health Postgraduate Research Scholarship (ID: 1075456) and a scholarship funded through the NHMRC Aus-ROC CRE. JB receives an early career researcher fellowship from the NHMRC and the Heart Foundation. JF receives salary support from St John Ambulance Western Australia.