Out-of-hospital cardiac arrests and bystander response by socioeconomic disadvantage in communities of New South Wales, Australia
Background & aim: Bystander response to out-of-hospital cardiac arrest (OHCA) may relate to area-level factors, including socioeconomic status (SES). We aimed to examine whether OHCA among individuals in more disadvantaged areas are less likely to receive bystander cardiopulmonary resuscitat...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-03-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520422000054 |
| _version_ | 1818894489682444288 |
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| author | Sonali Munot Emily J. Rugel Amy Von Huben Simone Marschner Julie Redfern Sandra Ware Clara K. Chow |
| author_facet | Sonali Munot Emily J. Rugel Amy Von Huben Simone Marschner Julie Redfern Sandra Ware Clara K. Chow |
| author_sort | Sonali Munot |
| collection | DOAJ |
| description | Background & aim: Bystander response to out-of-hospital cardiac arrest (OHCA) may relate to area-level factors, including socioeconomic status (SES). We aimed to examine whether OHCA among individuals in more disadvantaged areas are less likely to receive bystander cardiopulmonary resuscitation (CPR) compared to those in more advantaged areas. Methods: We analysed data on OHCAs in New South Wales, Australia collected prospectively through a statewide, population-based register. We excluded non-medical arrests; arrests witnessed by a paramedic; occurring in a medical centre, nursing home, police station; or airport, and among individuals with a Do-Not-Resuscitate order. Area-level SES for each arrest was defined using the Australian Bureau of Statistics’ Index of Relative Socioeconomic Disadvantage and its relationship to likelihood of receiving bystander CPR was examined using hierarchical logistic regression models. Results: Overall, 39% (6622/16,914) of arrests received bystander CPR (71% of bystander-witnessed). The OHCA burden in disadvantaged areas was higher (age-standardised incidence 76–87/100,000/year in more disadvantaged quintiles 1–4 versus 52 per 100,000/year in most advantaged quintile 5). Bystander CPR rates were lower (38%) in the most disadvantaged quintile and highest (42%) in the most advantaged SES quintile. In adjusted models, younger age, being bystander-witnessed, arresting in a public location, and urban location were all associated with greater likelihood of receiving bystander CPR; however, the association between area-level SES and bystander CPR rate was not significant. Conclusions: There are lower rates of bystander CPR in less advantaged areas, however after accounting for patient and location characteristics, area-level SES was not associated with bystander CPR. Concerted efforts to engage with communities to improve bystander CPR in novel ways could improve OHCA outcomes. |
| first_indexed | 2024-12-19T18:29:19Z |
| format | Article |
| id | doaj.art-fa4cf1ece1ec485da68d7621e9f7c525 |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-12-19T18:29:19Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-fa4cf1ece1ec485da68d7621e9f7c5252022-12-21T20:10:46ZengElsevierResuscitation Plus2666-52042022-03-019100205Out-of-hospital cardiac arrests and bystander response by socioeconomic disadvantage in communities of New South Wales, AustraliaSonali Munot0Emily J. Rugel1Amy Von Huben2Simone Marschner3Julie Redfern4Sandra Ware5Clara K. Chow6Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, AustraliaWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, CanadaWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, AustraliaWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, AustraliaSchool of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; The George Institute for Global Health, University of New South Wales, Newtown, AustraliaNSW Ambulance, Sydney, New South Wales, AustraliaWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; The George Institute for Global Health, University of New South Wales, Newtown, Australia; Department of Cardiology, Westmead Hospital, Sydney, Australia; Corresponding author at: Department of Cardiology, Westmead Hospital, Westmead Applied Research Centre, The University of Sydney, Westmead Hospital, Westmead, New South Wales 2145, Australia.Background & aim: Bystander response to out-of-hospital cardiac arrest (OHCA) may relate to area-level factors, including socioeconomic status (SES). We aimed to examine whether OHCA among individuals in more disadvantaged areas are less likely to receive bystander cardiopulmonary resuscitation (CPR) compared to those in more advantaged areas. Methods: We analysed data on OHCAs in New South Wales, Australia collected prospectively through a statewide, population-based register. We excluded non-medical arrests; arrests witnessed by a paramedic; occurring in a medical centre, nursing home, police station; or airport, and among individuals with a Do-Not-Resuscitate order. Area-level SES for each arrest was defined using the Australian Bureau of Statistics’ Index of Relative Socioeconomic Disadvantage and its relationship to likelihood of receiving bystander CPR was examined using hierarchical logistic regression models. Results: Overall, 39% (6622/16,914) of arrests received bystander CPR (71% of bystander-witnessed). The OHCA burden in disadvantaged areas was higher (age-standardised incidence 76–87/100,000/year in more disadvantaged quintiles 1–4 versus 52 per 100,000/year in most advantaged quintile 5). Bystander CPR rates were lower (38%) in the most disadvantaged quintile and highest (42%) in the most advantaged SES quintile. In adjusted models, younger age, being bystander-witnessed, arresting in a public location, and urban location were all associated with greater likelihood of receiving bystander CPR; however, the association between area-level SES and bystander CPR rate was not significant. Conclusions: There are lower rates of bystander CPR in less advantaged areas, however after accounting for patient and location characteristics, area-level SES was not associated with bystander CPR. Concerted efforts to engage with communities to improve bystander CPR in novel ways could improve OHCA outcomes.http://www.sciencedirect.com/science/article/pii/S2666520422000054Out-of-hospital cardiac arrestBystander cardiopulmonary resuscitationSocioeconomic statusHealth equityAdministrative data |
| spellingShingle | Sonali Munot Emily J. Rugel Amy Von Huben Simone Marschner Julie Redfern Sandra Ware Clara K. Chow Out-of-hospital cardiac arrests and bystander response by socioeconomic disadvantage in communities of New South Wales, Australia Resuscitation Plus Out-of-hospital cardiac arrest Bystander cardiopulmonary resuscitation Socioeconomic status Health equity Administrative data |
| title | Out-of-hospital cardiac arrests and bystander response by socioeconomic disadvantage in communities of New South Wales, Australia |
| title_full | Out-of-hospital cardiac arrests and bystander response by socioeconomic disadvantage in communities of New South Wales, Australia |
| title_fullStr | Out-of-hospital cardiac arrests and bystander response by socioeconomic disadvantage in communities of New South Wales, Australia |
| title_full_unstemmed | Out-of-hospital cardiac arrests and bystander response by socioeconomic disadvantage in communities of New South Wales, Australia |
| title_short | Out-of-hospital cardiac arrests and bystander response by socioeconomic disadvantage in communities of New South Wales, Australia |
| title_sort | out of hospital cardiac arrests and bystander response by socioeconomic disadvantage in communities of new south wales australia |
| topic | Out-of-hospital cardiac arrest Bystander cardiopulmonary resuscitation Socioeconomic status Health equity Administrative data |
| url | http://www.sciencedirect.com/science/article/pii/S2666520422000054 |
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