Benjamin Dahan1, Patricia Jabre2, Nicole Karam3, Renaud Misslin4, Muriel Tafflet5, Wulfran Bougouin3, Daniel Jost6, Frankie Beganton5, Eloi Marijon7, Xavier Jouven7. 1. Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France; AP-HP, SMUR, Hôpital Lariboisière, Paris, France; Université Paris Descartes-Paris V, Paris, France. Electronic address: benjamin.dahan@inserm.fr. 2. Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France; AP-HP, Samu de Paris, Hôpital Necker-Enfants Malades, Paris, France. 3. Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France; AP-HP, Service de Cardiologie, Hôpital Européen Georges Pompidou, Paris, France. 4. Université de Rouen, Laboratoire IDEES, UMR CNRS 6266 IDEES, France. 5. Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France. 6. Brigade des Sapeurs-Pompiers de Paris, Paris, France. 7. Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France; Université Paris Descartes-Paris V, Paris, France; AP-HP, Service de Cardiologie, Hôpital Européen Georges Pompidou, Paris, France.
Abstract
BACKGROUND: No European data currently describe the relation between neighbourhood socio-economic status (SES) and rates of out-of-hospital cardiac arrest (OHCA) bystander cardiopulmonary resuscitation (CPR). This study aims to analyse this effect with a robust deprivation index. METHODS: Data about all OHCA in Paris were collected prospectively between 2000 and 2010. A geographical neighbourhood unit was assigned to each case. Median household income, and rates of blue-collar workers, unemployment, and adults without high school diplomas were selected as SES characteristics and used to classify neighbourhoods as low SES or higher SES. We analysed the relationship between neighbourhood SES characteristics and the probability of receiving bystander CPR. RESULTS: Of the 4009 OHCA with mappable addresses recorded, 777 (19.4%) received bystander CPR. Compared to OHCA who did not receive bystander CPR, those receiving CPR were significantly more likely to have occurred in public locations, have had a witness to their OHCA, and not to have collapsed in a low SES neighbourhood, or in a neighbourhood with a median household income in the lowest quartile and with rates of no high school diplomas and blue-collar workers in the highest quartile. In the multilevel analyses, bystander CPR provision was significantly less frequent in low than in higher SES neighbourhoods (OR 0.85; 95% confidence interval [CI] 0.72-0.99). CONCLUSION: In the city of Paris, OHCA victims were less likely to receive bystander CPR in low SES neighbourhoods. These first European data are consistent with observations in North America and Asia.
BACKGROUND: No European data currently describe the relation between neighbourhood socio-economic status (SES) and rates of out-of-hospital cardiac arrest (OHCA) bystander cardiopulmonary resuscitation (CPR). This study aims to analyse this effect with a robust deprivation index. METHODS: Data about all OHCA in Paris were collected prospectively between 2000 and 2010. A geographical neighbourhood unit was assigned to each case. Median household income, and rates of blue-collar workers, unemployment, and adults without high school diplomas were selected as SES characteristics and used to classify neighbourhoods as low SES or higher SES. We analysed the relationship between neighbourhood SES characteristics and the probability of receiving bystander CPR. RESULTS: Of the 4009 OHCA with mappable addresses recorded, 777 (19.4%) received bystander CPR. Compared to OHCA who did not receive bystander CPR, those receiving CPR were significantly more likely to have occurred in public locations, have had a witness to their OHCA, and not to have collapsed in a low SES neighbourhood, or in a neighbourhood with a median household income in the lowest quartile and with rates of no high school diplomas and blue-collar workers in the highest quartile. In the multilevel analyses, bystander CPR provision was significantly less frequent in low than in higher SES neighbourhoods (OR 0.85; 95% confidence interval [CI] 0.72-0.99). CONCLUSION: In the city of Paris, OHCA victims were less likely to receive bystander CPR in low SES neighbourhoods. These first European data are consistent with observations in North America and Asia.
Authors: Sarah S Gul; Scott A Cohen; Torben K Becker; Karl Huesgen; Jason M Jones; Joseph A Tyndall Journal: Prehosp Emerg Care Date: 2019-08-05 Impact factor: 3.077
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