Association of neighborhood characteristics with bystander-initiated CPR
Comilla Sasson, David J Magid, Paul Chan, Elisabeth D Root, Bryan F McNally, Arthur L Kellermann, Jason S Haukoos, CARES Surveillance Group, Mike Levy, Joseph Barger, James V Dunford, Karl Sporer, Angelo Salvucci, David Ross, Christopher Colwell, Dorothy Turnbull, Rob Rosenbaum, Kathleen Schrank, Mark Waterman, Richard Dukes, Raymond Fowler, John Lloyd, Art Yancey, Earl Grubbs, John Lloyd, Johnathan Morris, Stephen Boyle, Troy Johnson, Christopher Wizner, Melissa White, Sabina Braithwaite, Sophia Dyer, Gary Setnik, Bob Hassett, John Santor, Bob Swor, Todd Chassee, Charlie Lick, Mike Parrish, Darel Radde, Brian Mahoney, Darell Todd, Joseph Salomone, Eric Ossman, Brent Myers, Lee Garvey, James Camerson, David Slattery, Joseph Ryan, Jason McMullan, David Keseg, James Leaming, B K Sherwood, Jeff Luther, Corey Slovis, Paul Hinchey, Michael Harrington, John Griswell, Jeff Beeson, David Persse, Mark Gamber, Joe Ornato, Comilla Sasson, David J Magid, Paul Chan, Elisabeth D Root, Bryan F McNally, Arthur L Kellermann, Jason S Haukoos, CARES Surveillance Group, Mike Levy, Joseph Barger, James V Dunford, Karl Sporer, Angelo Salvucci, David Ross, Christopher Colwell, Dorothy Turnbull, Rob Rosenbaum, Kathleen Schrank, Mark Waterman, Richard Dukes, Raymond Fowler, John Lloyd, Art Yancey, Earl Grubbs, John Lloyd, Johnathan Morris, Stephen Boyle, Troy Johnson, Christopher Wizner, Melissa White, Sabina Braithwaite, Sophia Dyer, Gary Setnik, Bob Hassett, John Santor, Bob Swor, Todd Chassee, Charlie Lick, Mike Parrish, Darel Radde, Brian Mahoney, Darell Todd, Joseph Salomone, Eric Ossman, Brent Myers, Lee Garvey, James Camerson, David Slattery, Joseph Ryan, Jason McMullan, David Keseg, James Leaming, B K Sherwood, Jeff Luther, Corey Slovis, Paul Hinchey, Michael Harrington, John Griswell, Jeff Beeson, David Persse, Mark Gamber, Joe Ornato
Abstract
Background: For persons who have an out-of-hospital cardiac arrest, the probability of receiving bystander-initiated cardiopulmonary resuscitation (CPR) may be influenced by neighborhood characteristics.
Methods: We analyzed surveillance data prospectively submitted from 29 U.S. sites to the Cardiac Arrest Registry to Enhance Survival between October 1, 2005, and December 31, 2009. The neighborhood in which each cardiac arrest occurred was determined from census-tract data. We classified neighborhoods as high-income or low-income on the basis of a median household income threshold of $40,000 and as white or black if more than 80% of the census tract was predominantly of one race. Neighborhoods without a predominant racial composition were classified as integrated. We analyzed the relationship between the median income and racial composition of a neighborhood and the performance of bystander-initiated CPR.
Results: Among 14,225 patients with cardiac arrest, bystander-initiated CPR was provided to 4068 (28.6%). As compared with patients who had a cardiac arrest in high-income white neighborhoods, those in low-income black neighborhoods were less likely to receive bystander-initiated CPR (odds ratio, 0.49; 95% confidence interval [CI], 0.41 to 0.58). The same was true of patients with cardiac arrest in neighborhoods characterized as low-income white (odds ratio, 0.65; 95% CI, 0.51 to 0.82), low-income integrated (odds ratio, 0.62; 95% CI, 0.56 to 0.70), and high-income black (odds ratio, 0.77; 95% CI, 0.68 to 0.86). The odds ratio for bystander-initiated CPR in high-income integrated neighborhoods (1.03; 95% CI, 0.64 to 1.65) was similar to that for high-income white neighborhoods.
Conclusions: In a large cohort study, we found that patients who had an out-of-hospital cardiac arrest in low-income black neighborhoods were less likely to receive bystander-initiated CPR than those in high-income white neighborhoods. (Funded by the Centers for Disease Control and Prevention and others.).
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Source: PubMed