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. 2011 Jun;82(6):674-9.
doi: 10.1016/j.resuscitation.2011.02.002. Epub 2011 Mar 31.

Examining the contextual effects of neighborhood on out-of-hospital cardiac arrest and the provision of bystander cardiopulmonary resuscitation

Comilla Sasson  1 , Carla C Keirns, Dylan M Smith, Michael R Sayre, Michelle L Macy, William J Meurer, Bryan F McNally, Arthur L Kellermann, Theodore J Iwashyna
Affiliations

Examining the contextual effects of neighborhood on out-of-hospital cardiac arrest and the provision of bystander cardiopulmonary resuscitation

Comilla Sasson et al. Resuscitation. 2011 Jun.

Abstract

Objective: To understand the association between neighborhood and individual characteristics in determining whether or not bystanders perform cardiopulmonary resuscitation (CPR) in cases of out-of-hospital cardiac arrest (OHCA).

Methods: Between October 1, 2005 to November 30, 2008, 1108 OHCA cases from Fulton County (Atlanta), GA, were eligible for bystander CPR. We conducted multi-level non-linear regression analysis and derived Empirical Bayes estimates for bystander CPR by census tract.

Results: 279 (25%) cardiac arrest victims received bystander CPR. Provision of bystander CPR was significantly more common in witnessed events (odds ratio [OR] 1.64; 95% confidence interval [CI] 1.21-2.22, p < 0.001) and those that occurred in public locations (OR 1.67; 95% CI 1.16-2.40, p < 0.001). Other individual-level characteristics were not significantly associated with bystander CPR. Cardiac arrests in the census tracts that rank in the highest income quintile, as compared to the lowest income quintile were much more likely (OR 4.98; 95% CI 1.65-15.04) to receive bystander CPR.

Conclusion: Cardiac arrest victims in the highest income census tracts were much more likely to receive bystander CPR than in the lowest income census tracts, even after controlling for individual and arrest characteristics. Low-income neighborhoods may be particularly appropriate targets for community-based CPR training and awareness efforts.

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Figures

Figure 1
Figure 1
Distribution of Median Household Income by Census Tract in Fulton County, Atlanta Georgia
Figure 2
Figure 2
Distribution of Adjusted Bystander CPR Prevalence by Census Tract in Fulton County, Atlanta Georgia
See this image and copyright information in PMC

Comment in

  • Measure and improve.
    Kwok H, Rea T. Kwok H, et al. Resuscitation. 2011 Jun;82(6):645-6. doi: 10.1016/j.resuscitation.2011.03.016. Epub 2011 Apr 12. Resuscitation. 2011. PMID: 21489679 No abstract available.

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