Association of Neighborhood Characteristics With Bystander-Initiated CPR

Abstract

BACKGROUND-For persons who have an out-of-hospital cardiac arrest, the probability of receiving bystander-initiated cardiopulmonary resuscitation (CPR) may be influenced by neighborhood characteristics.

Does location matter? A proposed methodology to evaluate neighbourhood effects on cardiac arrest survival and bystander CPR

“…Census tracts consist of relatively small homogeneous subsets of the population with about 2,500-6,000 people ( Figure 1) 31 and have been used previously when studying the role of location in OHCA outcomes. 8,9,[11][12][13][14]17,23,32 The patient's home address will be used in the analysis for survival-to-hospital discharge (and a ROSC at ED arrival) under the premise that survival is dependent on both the event and patient characteristics. The patient's home neighbourhood will be used as a surrogate for patient characteristics, because previous literature shows an association between home neighbourhood and cardiac risk factors, unhealthy behaviours, and overall health.…”

“…[33][34][35][36][37][38][39][40][41][42][43][44][45] The neighbourhood factors of the arrest location (i.e., the pickup address) will be used to study the effects on bystander CPR, because the emergency response (i.e., bystanders and EMS/paramedics) is contingent on the arrest location. [10][11][12][13][46][47][48] A patient's home address is recorded as mailing address with street name, street number, and postal code, whereas the pickup address is recorded as a mailing address, with latitude and longitude coordinates and a Universal Transverse Mercator (UTM) value. 28 Postal codes will be the preferred source for identifying addresses.…”

“…26 Sasson et al evaluated collectively the influence of neighbourhood median household income and racial composition on the probability of receiving bystander CPR. 13 They found that when compared to high-income Caucasian neighbourhoods, bystander CPR was less likely to occur in all neighbourhoods except those racially integrated with high median household incomes. 13 Aside from a few prior studies, the majority of the literature has explored SES as a single variable (i.e., median household income or property tax value) with widely differing results.…”

“…13 They found that when compared to high-income Caucasian neighbourhoods, bystander CPR was less likely to occur in all neighbourhoods except those racially integrated with high median household incomes. 13 Aside from a few prior studies, the majority of the literature has explored SES as a single variable (i.e., median household income or property tax value) with widely differing results. No study has been conducted in a Canadian setting, and none has collectively evaluated geographic, environmental, social, and cultural factors.…”

“…7 But despite the vast amount of evidence implicating the Utstein variables as the main predictors of survival, few studies to date have investigated non-Utstein variables as predictors of survival and their influence on outcome variability. 3,7 In OHCA, socioeconomic status (SES) [8][9][10][11][12][13][14] and race/ ethnicity [14][15][16][17][18][19][20][21][22][23][24] have been studied in relation to survivalto-hospital discharge and bystander CPR. These results are often contradictory and inconclusive, and these studies were limited in scope, only including one or two non-Utstein variables.…”