Abstract 12681: Associations Between Individual-level and Census Tract-level Characteristics and Performance of Bystander CPR Among Patients Who Experience Out-of-Hospital Cardiac Arrest
Objective: To estimate the association between individual and census tract characteristics on a patient's likelihood of receiving cardiopulmonary resuscitation (CPR) during an out-of-hospital cardiac arrest (OHCA) event.
Methods: Design: Secondary analysis of the Denver, Colorado component of the Cardiac Arrest Registry to Enhance Survival (CARES) dataset. Setting: Large urban metropolitan community with a single two-tiered EMS system. The catchment area for this community is approximately 150 square miles with an approximate census of 550,000 people and includes 10 adult acute-care receiving hospitals. Population: Consecutive arrests from January 1, 2009 through December 31, 2009. Data Analysis: Arrests were geocoded into census tracts based on the address of the event and census-tract variables. Hierarchical logistic regression analysis was used to examine the associations between individual and census-tract characteristics and whether individuals received bystander CPR. Crude census tract rates of cardiac arrest incidence and bystander CPR were also calculated.
Results: During the study period, 356 patients experienced OHCA. Of the 263 arrests in the final sample, 60 (22.8%) received bystander CPR. In the fully adjusted model, including both individual and census tract characteristics, patients who received bystander CPR were more likely to be female (odds ratio [OR] 2.10 95% confidence interval [CI] 1.01–4.39), have a witnessed arrest (OR 2.24; 95% CI 1.11–4.50), occur in a public location (OR 3.56; 95% CI 1.48–8.53), and occur in a census tract with fewer single-person householders (OR 0.95; 95% CI 0.91-0.99) and more high school graduates (OR 1.05; 95% CI 1.00–1.10). Crude incidence rates for OHCA varied from 0.86–3.40 per 1,000 persons, with bystander CPR rates varying from 0%–100% in census tracts.
Conclusions: We identified characteristics, at both the individual and census tract levels, that are associated with not receiving bystander CPR following OHCA. Further research will be required to identify specific census tracts with these characteristics that may be targets for community-based interventions. Scarce public health resources, such as CPR training and cardiovascular disease education, may then be focused in these areas.
- © 2010 by American Heart Association, Inc.