Bystander-initiated CPR in an Asian metropolitan: Does the socioeconomic status matter?

Wen Chu Chiang, Patrick Chow In Ko, Anna Marie Chang, Wei Ting Chen, Sot Shih Hung Liu, Yu Sheng Huang, Shey Ying Chen, Chien Hao Lin, Ming Tai Cheng, Kah Meng Chong, Hui Chih Wang, Chih Wei Yang, Mao Wei Liao, Chen Hsiung Wang, Yu Chun Chien, Chi Hung Lin, Yueh Ping Liu, Bin Chou Lee, Kuo Long Chien, Mei Shu LaiMatthew Huei Ming Ma*

*Corresponding author for this work

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Objectives: To determine the association of neighborhood socioeconomic status (SES) with bystander-initiated cardiopulmonary resuscitation (CPR) and patient outcomes of out of hospital cardiac arrests (OHCAs) in an Asian metropolitan area. Methods: We performed a retrospective study in a prospectively collected cohort from the Utstein registry of adult non-traumatic OHCAs in Taipei, Taiwan. Average real estate value was assessed as the first proxy of SES. Twelve administrative districts in Taipei City were categorized into low versus high SES areas to test the association. The primary outcome was bystander-initiated CPR, and the secondary outcome was patient survival status. Factors associated with bystander-initiated CPR were adjusted for in multivariate analysis. The mean household income was assessed as the second proxy of SES to validate the association. Results: From January 1, 2008 to December 30, 2009, 3573 OHCAs received prehospital resuscitation in the community. Among these, 617 (17.3%) cases received bystander CPR. The proportion of bystander CPR in low-SES vs. high-SES areas was 14.5% vs. 19.6% (p < 0.01). Odds ratio of receiving bystander-initiated CPR in low-SES areas was 0.72 (95% confidence interval: [0.60-0.88]) after adjusting for age, gender, witnessed status, public collapse, and OHCA unrecognized by the online dispatcher. Survival to discharge rate was significantly lower in low-SES areas vs. high-SES areas (4.3% vs. 6.8%; p < 0.01). All results above remained consistent in the analyses by mean household income. Conclusions: Patients who experienced an OHCA in low-SES areas were less likely to receive bystander-initiated CPR, and demonstrated worse survival outcomes.

Original languageEnglish
Pages (from-to)53-58
Number of pages6
JournalResuscitation
Volume85
Issue number1
DOIs
StatePublished - Jan 2014

Keywords

  • Cardiopulmonary resuscitation (CPR)
  • Education
  • Emergency medical system (EMS)
  • First responder
  • Neighborhood
  • Socioeconomic status (SES)

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    Chiang, W. C., Ko, P. C. I., Chang, A. M., Chen, W. T., Liu, S. S. H., Huang, Y. S., Chen, S. Y., Lin, C. H., Cheng, M. T., Chong, K. M., Wang, H. C., Yang, C. W., Liao, M. W., Wang, C. H., Chien, Y. C., Lin, C. H., Liu, Y. P., Lee, B. C., Chien, K. L., ... Ma, M. H. M. (2014). Bystander-initiated CPR in an Asian metropolitan: Does the socioeconomic status matter? Resuscitation, 85(1), 53-58. https://doi.org/10.1016/j.resuscitation.2013.07.033