Abstract:
OBJECTIVE:A 10-fold regional variation in survival after out-of-hospital cardiac arrest (OHCA) has been reported in the United States, which partly relates to variability in bystander cardiopulmonary resuscitation (CPR) rates. In order for resources to be focused on areas of greatest need, we conducted a geospatial analysis of variation of CPR rates. METHODS:Using 2010-2011 data from Durham, Mecklenburg, and Wake counties 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 logistic regression modeling were used to assess incidence of OHCA and patterns of bystander CPR according to census tracts and factors associated herewith. RESULTS:In total, 1466 patients were included (median age, 65 years [interquartile range 25]; 63.4% men). Bystander CPR by a layperson was initiated in 37.9% of these patients. High-incidence OHCA areas were characterized partly by higher population densities and higher percentages of black race as well as lower levels of education and income. Low rates of bystander CPR were associated with population composition (percent black: OR, 3.73; 95% CI, 2.00-6.97 per 1% increment in black patients; percent elderly: 3.25; 1.41-7.48 per 1% increment in elderly patients; percent living in poverty: 1.77, 1.16-2.71 per 1% increase in patients living in poverty). CONCLUSIONS:In 3 counties in North Carolina, areas with low rates of bystander CPR can be identified using geospatial data, and education efforts can be targeted to improve recognition of cardiac arrest and to augment bystander CPR rates.
journal_name
Resuscitationjournal_title
Resuscitationauthors
Fosbøl EL,Dupre ME,Strauss B,Swanson DR,Myers B,McNally BF,Anderson ML,Bagai A,Monk L,Garvey JL,Bitner M,Jollis JG,Granger CBdoi
10.1016/j.resuscitation.2014.08.013subject
Has Abstractpub_date
2014-11-01 00:00:00pages
1512-7issue
11eissn
0300-9572issn
1873-1570pii
S0300-9572(14)00715-1journal_volume
85pub_type
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