Abstract 18502: Association Between Socioeconomic Status of Neighborhoods and the Provision of Bystander Cardiopulmonary Resuscitation: A Systematic Review and Meta-Analysis
Introduction: Early provision of bystander-initiated cardiopulmonary resuscitation (BCPR) is a vital determinant of survival for Out-of-hospital Cardiac Arrest (OHCA) but the BCPR rates remain unsatisfactory. To evaluate whether the presence of certain socioeconomic factors had influenced the odds of BCPR, we conducted a systematic review and meta-analysis to assess the association between some of the quantifiable socioeconomic factors of neighborhood on rates of BCPR provision.
Methods: We searched PubMed and Embase from 1 January 1966 to June 1 2016. We selected median household income and real estate (property) value as the surrogates of neighborhood socioeconomic status (SES), and investigated their associations in the odds of BCPR provision as the outcome. Studies that were surveys, interviews, or reported outcomes qualitatively were excluded. If SES was expressed as more than two categorical variables or continuous variables in the selected studies, we dichotomized the SES into low or high and reconstruct the binary OR accordingly. Odds ratio (OR) was used as effect estimate and were reconstructed if not provided in the original articles.
Results: Fifteen studies were assessed for eligibility from 731 references. Of them, 6 studies were excluded for lacking the exposure of interest and 4 studies were excluded due to the use of duplicate dataset. Finally, 5 studies were selected for analysis. Of them, 4 studies used median household income and 3 studies used real estate value as the surrogates of the neighborhood SES. Meta-analysis indicated that the likelihood of receiving bystander CPR decreased with lower median household income (OR, 0.71; 95% CI, 0.63-0.80; I2, 56.9%; 4 studies) and lower real estate value (OR, 0.73; 95% CI, 0.66-0.81; I2, 0%; 3 studies).
Conclusions: By using surrogates of median household income and real estate value, this review provides evidence of a consistent association between lower SES and lower rate of BCPR. The underlying reasons linking to such association demand further investigation. Future CPR training and public education should be targeted in such high risk residential areas.
Author Disclosures: T. Lu: None. Y. Lin: None. M. Hsieh: None. W. Chiang: None. M.H. Ma: None.
- © 2016 by American Heart Association, Inc.