Journal of the American College of Emergency Physicians Open (Aug 2020)

Association of race and socioeconomic status with the rate of bystander‐initiated CPR in Memphis

  • Joshua M. Justice,
  • Joseph E. Holley,
  • Mark F. Brady,
  • James R. Walker

DOI
https://doi.org/10.1002/emp2.12095
Journal volume & issue
Vol. 1, no. 4
pp. 440 – 444

Abstract

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Abstract Study objective This study evaluated the association of race and socioeconomic status with the rate of bystander cardiopulmonary resuscitation (CPR) in out‐of‐hospital cardiac arrest in Memphis, TN and compared it to 25 years prior. Methods This was a retrospective cross‐sectional study of out‐of‐hospital cardiac arrest events in the Memphis area from 2012–2018. The primary outcome of interest was the provision of bystander CPR. Socioeconomic status was estimated using the Economic Hardship Index model. A generalized linear mixed model analysis was conducted. Results The overall rate of bystander CPR was 33.6%. White patients were more likely to receive bystander CPR compared to black patients (44.0% vs 29.8%, adjusted odds ratio [OR] = 1.70; 95% confidence interval [CI] = 1.40–2.05). Patients in areas of increased economic hardship were less likely to receive bystander CPR (OR = 0.713, 95% CI = 0.569–0.894). Overall bystander CPR rate increased by 18.7% over the past 25 years. Conclusion Despite significant increases in bystander CPR compared to 25 years ago, black individuals are still less likely to receive bystander CPR than white individuals in Memphis. Both race and socioeconomic status were independent predictors of the rate of bystander CPR. By using neighborhood demographics and the Economic Hardship Index, communities with low overall bystander CPR rates, such as Memphis, can focus limited resources on areas of greatest need and potential effectiveness.