Interaction effects between highly-educated neighborhoods and dispatcher-provided instructions on provision of bystander cardiopulmonary resuscitation.
- Authors
- Lee, Sun Young; Ro, Young Sun; Shin, Sang Do; Song, Kyoung Jun; Ahn, Ki Ok; Kim, Min Jung; Hong, Sung Ok; Kim, Young Taek
- Issue Date
- Feb-2016
- Publisher
- ELSEVIER IRELAND LTD
- Keywords
- Out-of-hospital cardiac arrest; Education; Cardiopulmonary resuscitation; Community
- Citation
- RESUSCITATION, v.99, pp.84 - 91
- Indexed
- SCIE
SCOPUS
- Journal Title
- RESUSCITATION
- Volume
- 99
- Start Page
- 84
- End Page
- 91
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/155107
- DOI
- 10.1016/j.resuscitation.2015.11.027
- ISSN
- 1748-3107
- Abstract
- Background: Socioeconomic factors of a community are associated with bystander cardiopulmonary resuscitation (BCPR) rates and outcomes of out-of-hospital cardiac arrest (OHCA). This study aimed to test whether dispatcher-provided CPR instruction modifies the association between education level of a community and provision of BCPR.
Methods: A population-based observational study was conducted with OHCAs of cardiac etiology who were witnessed by laypersons between 2012 and 2013. Exposure variable was the proportion of highly-educated residents (high school graduates and higher) in a community categorized into quartile groups. Endpoints were provision of BCPR and early chest compression (<= 4 min of collapse, ECC). Multivariable logistic regression analysis was performed. A final model with an interaction term was evaluated to test interactive effects of community education level with dispatcher-provided CPR instruction.
Results: A total of 10,694 OHCAs were analyzed. BCPR was performed in 5112 (47.8%), and early CPR was done in 3080 (28.8%). Compared with the highest educated communities, AORs (95% CIs) for BCPR were 0.84 (0.74-0.95) in higher, 0.78 (0.66-0.92) in lower, and 0.71 (0.60-0.85) in the lowest educated communities. For ECC, AORs (95% CIs) were 0.81 (0.66-0.99) in lower and 0.62 (0.50-0.76) in the lowest. In an interaction model of 4122 OHCA patients who received dispatcher-provided CPR instruction, OHCAs occurring in higher (AOR: 0.80 (0.67-0.96)), lower (AOR: 0.67 (0.52-0.87)), and the lowest (AOR: 0.59 (0.43-0.82)) were less likely to receive BCPR compared with the highest educated communities.
Conclusion: OHCA patients in communities with a higher proportion of highly-educated residents were more likely to receive BCPR, and the disparity was more prominent in the group that received dispatcherprovided CPR instruction.
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