Abstract 16023: Bystander CPR is Clustered and Associated With Socioeconomic Characteristics: A Geospatial Analysis of Kent County, Michigan
Introduction: Geographic clustering of bystander CPR (bCPR) has been demonstrated in several US cities. Some have also found an association between bCPR and socioeconomic characteristics of communities in which OHCA occurred. We linked geocoded OHCA cases to census data in order to identify community socioeconomic features associated with bCPR.
Hypothesis: Bystander CPR is geographically clustered in Kent County, and is associated with socioeconomic features of the surrounding community.
Methods: Retrospective, observational, population-based, cohort study using the CARES dataset for Kent County, Michigan. We included adult, non-traumatic, EMS-treated OHCA from 2010-2015, excluding cases with on-site medical care. EMS dispatch addresses and case features were geocoded using ArcGIS software to create a population-adjusted density map of OHCA annual incidence. Moran’s I test assessed for spatial autocorrelation and clustering of OHCA cases, and Getis-Ord Gi tested for ‘hot’ and ‘cold’ spots of bCPR. American Community Survey Data was overlaid to link community features to each incidence of cardiac arrest. Aggregate characteristics of communities in which bCPR occurred were compared to those without bCPR using t-test or chi-square tests.
Results: Of 1,592 subjects, 1,486 met inclusion criteria (59.8±19.2 years; 63% male; 16% public location; 46% witnessed; 39% bCPR; 24% shockable rhythm; 10% AED shock). OHCA clusters in central Grand Rapids and southern suburbs. Central Grand Rapids and southern suburbs were less likely to receive bCPR (99% confidence), whereas eastern and northeastern suburbs were more likely to receive bCPR (99% confidence). Aggregate socioeconomic data for communities with OHCA are in the Table.
Conclusion: OHCA and bCPR are geographically clustered within Kent County. bCPR is associated with community socioeconomic features. Identifying these communities affords opportunity for targeted public health initiatives.
Author Disclosures: A. Uber: None. R.C. Sadler: None. T. Chassee: None. J.C. Reynolds: None.
- © 2016 by American Heart Association, Inc.