Interaction effects between highly-educated neighborhoods and dispatcher-provided instructions on provision of bystander cardiopulmonary resuscitation

被引：32

作者：

Lee, Sun Young ^{[1
]}

Ro, Young Sun ^{[2
]}

Shin, Sang Do ^{[1
]}

Song, Kyoung Jun ^{[1
]}

Ahn, Ki Ok ^{[2
]}

Kim, Min Jung ^{[2
]}

Hong, Sung Ok ^{[3
,4
]}

Kim, Young Taek ^{[3
,4
]}

机构：

[1] Seoul Natl Univ, Coll Med, Dept Emergency Med, Seoul, South Korea

[2] Seoul Natl Univ Hosp, Lab Emergency Med Serv, Biomed Res Inst, Seoul 110744, South Korea

[3] Korea Ctr Dis Control, Osong, South Korea

[4] Korea Ctr Prevent, Osong, South Korea

来源：

RESUSCITATION | 2016年 / 99卷

关键词：

Out-of-hospital cardiac arrest; Education; Cardiopulmonary resuscitation; Community; HOSPITAL CARDIAC-ARREST; AMERICAN-HEART-ASSOCIATION; SOCIOECONOMIC-STATUS; INITIATED CPR; HEALTH LITERACY; SURVIVAL; METROPOLITAN; COMPRESSION; MORTALITY; KNOWLEDGE;

D O I：

10.1016/j.resuscitation.2015.11.027

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

引用

页码：84 / 91

页数：8