The effect of building-level socioeconomic status on bystander cardiopulmonary resuscitation: a retrospective cohort study

Abstract Background/Introduction In out-of-hospital cardiac arrest (OHCA), bystander cardiopulmonary resuscitation (BCPR) increases survival [1]. Understanding the social determinants of BCPR receipt can inform design public health interventions to increase BCPR. The association socioeconomic status (SES) with is generally poorly understood. Purpose We aimed evaluate effect SES on in OHCA using a building-level marker. Methods This was retrospective cohort study based Singapore Pan-Asian Resuscitation Outcomes Study registry, an ongoing long-term prospective registry for Asia-Pacific region, between 2010 2018. categorized patients into low, medium and high Housing Index (SHI) levels. SHI, which appraises residential property value ordinal scale 1 7 (low high), marker that has robust income residence [2]. primary outcome secondary outcomes were pre-hospital return spontaneous circulation (ROSC) – defined as 30 days or hospital discharge, whichever occurred first. Results A total 12,730 cases included (Figure 1), median age 71 years 58.9% male. rate 56.7%. low SHI tier youngest, most likely male, least have any medical co-morbidities (Table 1). Compared category, those categories more receive (medium SHI: adjusted odds ratio [aOR] 1.483, 95% CI 1.301–1.691, p<0.01; aOR 1.933, 1.669–2.240, p<0.01). As continuous variable, every unit associated increased (aOR 1.142, 1.110–1.174, p<0.001). High had higher compared unadjusted analysis (OR 1.789, 1.080–2.964) but not (adjusted age, sex, race, witness status, time, past history cancer, first rhythm). There no significant differences proportion ROSC across three (p=0.426). When comparing females larger rates males (ratio OR 1.370, 1.012–1.853). associations subgroups ≥65 years, witnessed arrest, daytime arrests after 2014, interaction effects observed. Conclusions Lower independently lower Higher 30-day analysis, this may be under-powered outcome. Females susceptible BCPR, community CPR training should focus recognizing performing women communities. Funding Acknowledgement Type funding sources: Public grant(s) National budget only. Main source(s): Medical Research Council, Clinician Scientist Awards, (NMRC/CSA/024/2010, NMRC/CSA/0049/2013 NMRC/CSA-SI/0014/2017) Ministry Health, Health Services Grant, (HSRG/0021/2012).