- 作者：Wen-Chu Chiang ; Patrick Chow-In Ko ; Anna Marie Chang ; Wei-Ting Chen ; Sot Shih-Hung Liu ; Yu-Sheng Huang ; Shey-Ying Chen ; Chien-Hao Lin ; Ming-Tai Cheng ; Kah-Meng Chong ; Hui-Chih Wang ; Chih-Wei Yang ; Mao-Wei Liao ; Chen-Hsiung Wang ; Yu-Chun Chien ; Chi-Hung Lin ; Yueh-Ping Liu ; Bin-Chou Lee ; Kuo-Long Chien ; Mei-Shu Lai ; Matthew Huei-Ming Ma ; et al.
- 关键词：Cardiopulmonary resuscitation (CPR) ; Emergency medical system (EMS) ; Education ; Socioeconomic status (SES) ; Neighborhood ; First responder
- 刊名：Resuscitation
- 出版年：January, 2014
- 年：2014
- 卷：85
- 期：1
- 页码：53-58
- 全文大小：492 K
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 the 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. The primary outcome was bystander-initiated CPR, and the 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 January 1, 2008 to December 30, 2009, 3573 OHCAs received prehospital resuscitation in the community. Among these, 617 (17.3%) cases received bystander CPR. The proportion of bystander CPR in low-SES vs. high-SES areas was 14.5% vs. 19.6% (p < 0.01). Odds ratio of receiving bystander-initiated CPR in low-SES areas was 0.72 (95% confidence interval: [0.60-0.88]) after adjusting for age, gender, witnessed status, public collapse, and OHCA unrecognized by the 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 the analyses by mean household income.
Conclusions
Patients who experienced an OHCA in low-SES areas were less likely to receive bystander-initiated CPR, and demonstrated worse survival outcomes.