Sun Young Lee1, Young Sun Ro2, Sang Do Shin3, Kyoung Jun Song4, Ki Ok Ahn5, Min Jung Kim6, Sung Ok Hong7, Young Taek Kim8. 1. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: sy2376@hanmail.net. 2. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: Ro.youngsun@gmail.com. 3. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: shinsangdo@medimail.co.kr. 4. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: skciva@gmail.com. 5. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: arendt75@gmail.com. 6. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: minkim229@gmail.com. 7. Korea Centers for Disease Control and Prevention, Osong, Republic of Korea. Electronic address: soh822@hanmail.net. 8. Korea Centers for Disease Control and Prevention, Osong, Republic of Korea. Electronic address: ruyoung@cdc.go.kr.
Abstract
BACKGROUND: Socioeconomic factors of a community are associated with bystander cardiopulmonary resuscitation (BCPR) rates and outcomes of out-of-hospital cardiac arrest (OHCA). This study aimed to test whether dispatcher-provided CPR instruction modifies the association between education level of a community and provision of BCPR. METHODS: A population-based observational study was conducted with OHCAs of cardiac etiology who were witnessed by laypersons between 2012 and 2013. Exposure variable was the proportion of highly-educated residents (high school graduates and higher) in a community categorized into quartile groups. Endpoints were provision of BCPR and early chest compression (≤4min of collapse, ECC). Multivariable logistic regression analysis was performed. A final model with an interaction term was evaluated to test interactive effects of community education level with dispatcher-provided CPR instruction. RESULTS: A total of 10,694 OHCAs were analyzed. BCPR was performed in 5112 (47.8%), and early CPR was done in 3080 (28.8%). Compared with the highest educated communities, AORs (95%CIs) for BCPR were 0.84 (0.74-0.95) in higher, 0.78 (0.66-0.92) in lower, and 0.71 (0.60-0.85) in the lowest educated communities. For ECC, AORs (95%CIs) were 0.81 (0.66-0.99) in lower and 0.62 (0.50-0.76) in the lowest. In an interaction model of 4122 OHCA patients who received dispatcher-provided CPR instruction, OHCAs occurring in higher (AOR: 0.80 (0.67-0.96)), lower (AOR: 0.67 (0.52-0.87)), and the lowest (AOR: 0.59 (0.43-0.82)) were less likely to receive BCPR compared with the highest educated communities. CONCLUSION: OHCA patients in communities with a higher proportion of highly-educated residents were more likely to receive BCPR, and the disparity was more prominent in the group that received dispatcher-provided CPR instruction.
BACKGROUND: Socioeconomic factors of a community are associated with bystander cardiopulmonary resuscitation (BCPR) rates and outcomes of out-of-hospital cardiac arrest (OHCA). This study aimed to test whether dispatcher-provided CPR instruction modifies the association between education level of a community and provision of BCPR. METHODS: A population-based observational study was conducted with OHCAs of cardiac etiology who were witnessed by laypersons between 2012 and 2013. Exposure variable was the proportion of highly-educated residents (high school graduates and higher) in a community categorized into quartile groups. Endpoints were provision of BCPR and early chest compression (≤4min of collapse, ECC). Multivariable logistic regression analysis was performed. A final model with an interaction term was evaluated to test interactive effects of community education level with dispatcher-provided CPR instruction. RESULTS: A total of 10,694 OHCAs were analyzed. BCPR was performed in 5112 (47.8%), and early CPR was done in 3080 (28.8%). Compared with the highest educated communities, AORs (95%CIs) for BCPR were 0.84 (0.74-0.95) in higher, 0.78 (0.66-0.92) in lower, and 0.71 (0.60-0.85) in the lowest educated communities. For ECC, AORs (95%CIs) were 0.81 (0.66-0.99) in lower and 0.62 (0.50-0.76) in the lowest. In an interaction model of 4122 OHCA patients who received dispatcher-provided CPR instruction, OHCAs occurring in higher (AOR: 0.80 (0.67-0.96)), lower (AOR: 0.67 (0.52-0.87)), and the lowest (AOR: 0.59 (0.43-0.82)) were less likely to receive BCPR compared with the highest educated communities. CONCLUSION: OHCA patients in communities with a higher proportion of highly-educated residents were more likely to receive BCPR, and the disparity was more prominent in the group that received dispatcher-provided CPR instruction.
Authors: Sun Young Lee; Seung Chul Lee; Sang Do Shin; Kyoung Jun Song; Young Sun Ro; Jeong Ho Park; So Yeon Kong Journal: PLoS One Date: 2018-03-26 Impact factor: 3.240
Authors: Maryam Y Naim; Heather M Griffis; Rita V Burke; Bryan F McNally; Lihai Song; Robert A Berg; Vinay M Nadkarni; Kimberly Vellano; David Markenson; Richard N Bradley; Joseph W Rossano Journal: J Am Heart Assoc Date: 2019-07-10 Impact factor: 5.501