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Variation in Bystander Cardiopulmonary Resuscitation Delivery and Subsequent Survival From Out-of-Hospital Cardiac Arrest Based on Neighborhood-Level Ethnic Characteristics.

Publication ,  Journal Article
Blewer, AL; Schmicker, RH; Morrison, LJ; Aufderheide, TP; Daya, M; Starks, MA; May, S; Idris, AH; Callaway, CW; Kudenchuk, PJ; Vilke, GM ...
Published in: Circulation
January 7, 2020

BACKGROUND: Bystander cardiopulmonary resuscitation (B-CPR) delivery and survival after out-of-hospital cardiac arrest vary at the neighborhood level, with lower survival seen in predominantly black neighborhoods. Although the Hispanic population is the fastest-growing minority population in the United States, few studies have assessed whether the proportion of Hispanic residents in a neighborhood is associated with B-CPR delivery and survival from out-of-hospital cardiac arrest. We assessed whether B-CPR rates and survival vary by neighborhood-level ethnicity. We hypothesized that neighborhoods with a higher proportion of Hispanic residents have lower B-CPR rates and lower survival. METHODS: We conducted a retrospective cohort study using data from the Resuscitation Outcomes Consortium Epistry at US sites. Neighborhoods were classified by census tract based on percentage of Hispanic residents: <25%, 25% to 50%, 51% to 75%, or >75%. We independently modeled the likelihood of receipt of B-CPR and survival by neighborhood-level ethnicity controlling for site and patient-level confounding characteristics. RESULTS: From 2011 to 2015, the Resuscitation Outcomes Consortium collected 27 481 US arrest events; after excluding pediatric arrests, emergency medical services-witnessed arrests, or arrests occurring in a healthcare or institutional facility, 18 927 were included. B-CPR was administered in 37% of events. In neighborhoods with <25% Hispanic residents, B-CPR was administered in 39% of events, whereas it was administered in 27% of events in neighborhoods with >75% Hispanic residents. Compared with <25% Hispanic neighborhoods in a multivariable analysis, out-of-hospital cardiac arrest in predominantly Hispanic neighborhoods had lower B-CPR rates (51% to 75% Hispanic: odds ratio, 0.79 [CI, 0.65-0.95], P=0.014; >75% Hispanic: odds ratio, 0.72 [CI, 0.55-0.96], P=0.025) and lower survival rates (global P value 0.029; >75% Hispanic: odds ratio, 0.56 [CI, 0.34-0.93], P=0.023). CONCLUSIONS: Individuals with out-of-hospital cardiac arrest in predominantly Hispanic neighborhoods were less likely to receive B-CPR and had lower likelihood of survival. These findings suggest a need to understand the underlying disparities in cardiopulmonary resuscitationdelivery and an unmet cardiopulmonary resuscitationtraining need in Hispanic communities.

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Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

January 7, 2020

Volume

141

Issue

1

Start / End Page

34 / 41

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Residence Characteristics
  • Prospective Studies
  • Out-of-Hospital Cardiac Arrest
  • Middle Aged
  • Male
  • Humans
  • Hispanic or Latino
  • Female
 

Citation

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Blewer, A. L., Schmicker, R. H., Morrison, L. J., Aufderheide, T. P., Daya, M., Starks, M. A., … Resuscitation Outcomes Consortium Investigators, . (2020). Variation in Bystander Cardiopulmonary Resuscitation Delivery and Subsequent Survival From Out-of-Hospital Cardiac Arrest Based on Neighborhood-Level Ethnic Characteristics. Circulation, 141(1), 34–41. https://doi.org/10.1161/CIRCULATIONAHA.119.041541
Blewer, Audrey L., Robert H. Schmicker, Laurie J. Morrison, Tom P. Aufderheide, Mohamud Daya, Monique A. Starks, Susanne May, et al. “Variation in Bystander Cardiopulmonary Resuscitation Delivery and Subsequent Survival From Out-of-Hospital Cardiac Arrest Based on Neighborhood-Level Ethnic Characteristics.Circulation 141, no. 1 (January 7, 2020): 34–41. https://doi.org/10.1161/CIRCULATIONAHA.119.041541.
Blewer AL, Schmicker RH, Morrison LJ, Aufderheide TP, Daya M, Starks MA, et al. Variation in Bystander Cardiopulmonary Resuscitation Delivery and Subsequent Survival From Out-of-Hospital Cardiac Arrest Based on Neighborhood-Level Ethnic Characteristics. Circulation. 2020 Jan 7;141(1):34–41.
Blewer, Audrey L., et al. “Variation in Bystander Cardiopulmonary Resuscitation Delivery and Subsequent Survival From Out-of-Hospital Cardiac Arrest Based on Neighborhood-Level Ethnic Characteristics.Circulation, vol. 141, no. 1, Jan. 2020, pp. 34–41. Pubmed, doi:10.1161/CIRCULATIONAHA.119.041541.
Blewer AL, Schmicker RH, Morrison LJ, Aufderheide TP, Daya M, Starks MA, May S, Idris AH, Callaway CW, Kudenchuk PJ, Vilke GM, Abella BS, Resuscitation Outcomes Consortium Investigators. Variation in Bystander Cardiopulmonary Resuscitation Delivery and Subsequent Survival From Out-of-Hospital Cardiac Arrest Based on Neighborhood-Level Ethnic Characteristics. Circulation. 2020 Jan 7;141(1):34–41.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

January 7, 2020

Volume

141

Issue

1

Start / End Page

34 / 41

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Residence Characteristics
  • Prospective Studies
  • Out-of-Hospital Cardiac Arrest
  • Middle Aged
  • Male
  • Humans
  • Hispanic or Latino
  • Female