Abstract 289: Geographic Factors Associated With High Risk for Out-Of Hospital Cardiac Arrests and Provision of Bystander Cardio-Pulmonary Resuscitation in Singapore
Objectives: The objectives were to investigate association of individual and population characteristics in the provision of Bystander Cardio-Pulmonary Resuscitation (BCPR) among OHCA cases happened at home and identify high risk residential areas with low risk of BCPR and high risk of Out-of-Hospital Cardiac Arrest (OHCA) at the Development Guide Plan (DGP) census tract levels in Singapore.
Methods: This was a retrospective, secondary analysis of two prospectively collected registries in Singapore from 2001 to 2011. We used Bayesian conditional autoregressive spatial models to examine predictors at the DGP level and to calculate smoothed relative risk (RR) to identify high risk clusters. We used multi-level mixed-effects logistic regression models to examine the independent effects of individual and neighborhood factors.
Results: We found a total of 3942 OHCA with BCPR rates of 20.3% and 3578 cases eligible for BCPR. OHCA cases receiving BCPR at home were more likely to be witnessed (OR=1.69, 95%CI=1.34-2.12), younger (OR=0.98, 95%CI=0.97-0.98), presumed cardiac etiology (OR=1.48, 95%CI=1.14-1.91) and had longer response time (OR=1.04, 95%CI=1.01-1.06). After adjusting for individual arrest characteristics, an increased risk of provision of BCPR was significantly related to higher proportion of household size five and above at areal level (RR=1.02, 95% Credible Interval=1.01-1.04). We identified 10 high risk residential areas.
Conclusion: We found differences in risk of receiving BCPR in different geographic areas. This study supported that neighborhood household size could play a significant role in the provision of BCPR and occurrence of high risk areas. Those high risk residential areas identified could be possible sites to target community based interventions (CPR training and public access defibrillation).
- © 2013 by American Heart Association, Inc.