June 9, 2010 (Atlanta, Georgia) — Registry data can identify neighborhoods that are most in need of help to improve bystander cardiopulmonary resuscitation (CPR) rates, results of a new study published online June 1, 2010 in the Annals of Internal Medicine show .
Dr Comilla Sasson (University of Michigan, Ann Arbor) and colleagues analyzed 1108 cases of out-of-hospital cardiac arrest in Fulton County, GA--which includes Atlanta--from 2005 through 2008 from the Cardiac Arrest Registry to Enhance, an emergency medical services (EMS) web-based registry of data from EMS logs and selected hospital information. The study excluded cases where CPR was performed by medical professionals, the cardiac arrest was witnessed by EMS personnel, or the arrest occurred at Hartsfield-Jackson airport, which is heavily monitored and has many trained responders and external defibrillators.
In the 1108 cases, 279 patients received bystander CPR. Of the 41 patients that survived to hospital discharge, 20 had received bystander CPR. The mean rate of bystander CPR for the whole sample was 25% but varied from 0% to 100% among neighborhoods, defined by US census tracts.
The study identified some census tracts with cardiac arrest rates up to three times as high as nearby areas as well as census tracts with much lower rates of bystander CPR than other parts of the same county, but there was little association between the incidence of cardiac arrests and the rates of bystander CPR.
According to the authors, this is the first study to show year-to-year stability in the incidence of cardiac arrest within census tracts and the first study to identify census tracts that have higher rates of cardiac arrest and relatively low rates of bystander CPR. Previously, these so-called "hot spots" have been inferred, but no study had shown they persist long enough to provide a useful target for intervention, Sasson et al explain. "These census tracts may be promising settings for heart health promotion, CPR training, public-access defibrillator placement, and other community-based interventions," the authors explain. "If we could improve rates of bystander CPR in the full sample to the level achieved by the highest-performing census tracts in Fulton County, an additional 355 persons would receive CPR. This could save an additional 15 lives each year."
Sasson declares no conflicts of interest. Disclosures for the coauthors are available at https://www.annals.org .
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