Out-of-hospital cardiac arrests and bystander response by socioeconomic disadvantage in communities of New South Wales, Australia

Sonali Munot; Emily J. Rugel; Amy Von Huben; Simone Marschner; Julie Redfern; Sandra Ware; Clara K. Chow

Resuscitation Plus (Mar 2022)

Out-of-hospital cardiac arrests and bystander response by socioeconomic disadvantage in communities of New South Wales, Australia

Sonali Munot,
Emily J. Rugel,
Amy Von Huben,
Simone Marschner,
Julie Redfern,
Sandra Ware,
Clara K. Chow

Affiliations

Sonali Munot: Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
Emily J. Rugel: Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
Amy Von Huben: Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
Simone Marschner: Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
Julie Redfern: School 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, Australia
Sandra Ware: NSW Ambulance, Sydney, New South Wales, Australia
Clara K. Chow: Westmead 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.

Journal volume & issue: Vol. 9
p. 100205

Abstract

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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.

Published in Resuscitation Plus

ISSN: 2666-5204 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine
Website: https://www.journals.elsevier.com/resuscitation-plus

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