Abstract 264: Bystander-initiated Cardiopulmonary Resuscitation in an Asian Community: Does the Socioeconomic Status Matter?

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 an 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. Primary outcome was bystander-initiated CPR, and 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 Jan. 1, 2008 to Dec. 30, 2009, 3573 OHCAs received prehospital resuscitation in the community. Among them, 617 (17.3%) cases received bystander CPR. Proportions of bystander CPR in low SES vs. high SES areas were 14.5% vs. 19.6% (p<0.01). Odds ratio (OR) of receiving bystander-initiated CPR were 0.72 (95% confidence interval (CI) 0.60-0.88) in low SES areas after adjusted by age, gender, witnessed status, public collapse, and unrecognized OHCA by 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 analyses by mean household income. Conclusions: Patients who had an OHCA in low SES areas were less likely to receive bystander CPR, as well as worse survival outcomes.