Author + information
- Emil L. Fosbol,
- Benjamin Strauss,
- Douglas Swanson,
- Brent Myers,
- Matthew Dupre,
- Brian McNally,
- Monique Anderson,
- Akshay Bagai,
- Lisa Monk,
- J. Garvey,
- Matthew Bitner,
- James Jollis and
- Christopher Granger
A five-fold regional variation in survival from out-of-hospital cardiac arrest cardiac arrest (OHCA) has been reported in the US, which in part is related to variability in rates of bystander CPR. More granular identification of bystander CPR rates at the neighborhood level could provide an opportunity to focus training efforts on areas of greatest need.
We used 2010-2011 data from three counties (Durham, Mecklenburg, and Wake) in North Carolina participating in the Cardiac Arrest Registry to Enhance Survival (CARES) program. We included all patients with OHCA for whom resuscitation was attempted. Geocoded data and multilevel models were used to assess the incidence of OHCA and patterns of bystander CPR according to census tracts and factors associated herewith.
A total of 2022 patients with OHCA were included (median age 66 years (IQR 24) and 61.5% men). Bystander CPR by a layperson was initiated in 36.5%. High incidence areas were characterized in part by higher percentage of black race, lower degree of education, higher median age, lower income, and a lower percentage of shockable rhythm at presentation. Low rates of bystander CPR were associated with various patient and neighborhood factors (Table).
In OHCA, areas with low rates of bystander CPR (e.g. communities with high proprotion of blacks and older adults) can be identified using geospatial data and education efforts can be targeted to such areas to improve recognition of cardiac arrest and augment CPR rates.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Disparities and Cardiovascular Epidemiology
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1244-100
- 2013 American College of Cardiology Foundation