Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
Department of Emergency Medicine, Baylor Scott & White All Saints Medical Center, Fort Worth, TX 76104, USA.
Int J Environ Res Public Health. 2021 Jan 29;18(3):1207. doi: 10.3390/ijerph18031207.
Few studies have investigated the association between dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) performance and the outcomes of out-of-hospital cardiac arrest (OHCA) among communities with different socioeconomic statuses (SES). A retrospective cohort study was conducted using an Utstein-style population OHCA database in Tainan, Taiwan, between January 2014 and December 2015. SES was defined based on real estate prices. The outcome measures included the achievement of return of spontaneous circulation (ROSC) and the performance of DA-CPR. Statistical significance was set at a two-tailed -value of less than 0.05. A total of 2928 OHCA cases were enrolled in the high SES ( = 1656, 56.6%), middle SES ( = 1025, 35.0%), and low SES ( = 247, 8.4%) groups. The high SES group had a significantly higher prehospital ROSC rate, ever ROSC rate, and sustained ROSC rate and good neurologic outcomes at discharge (all < 0.005). The low SES group, compared to the high and middle SES groups, had a significantly longer dispatcher recognition time ( = 0.004) and lower early (≤60 s) recognition rate ( = 0.029). The high SES group, but none of the DA-CPR measures, had significant associations with sustained ROSC in the multivariate regression model. The low SES group was associated with a longer time to dispatcher recognition of cardiac arrest and worse outcomes of OHCA. Strategies to promote public awareness of cardiac arrest could be tailored to neighborhood SES.
很少有研究调查调度员辅助心肺复苏（DA-CPR）表现与不同社会经济地位（SES）社区中院外心脏骤停（OHCA）结局之间的关系。本研究使用台湾台南地区的一个 Utstein 风格人群 OHCA 数据库进行了回顾性队列研究，时间为 2014 年 1 月至 2015 年 12 月。SES 是根据房地产价格来定义的。结局测量包括自主循环恢复（ROSC）的实现和 DA-CPR 的实施。统计学显著性定义为双侧 -值小于 0.05。共纳入了 SES 较高（ = 1656，56.6%）、SES 中等（ = 1025，35.0%）和 SES 较低（ = 247，8.4%）的三组共 2928 例 OHCA 病例。SES 较高组的院前 ROSC 率、既往 ROSC 率和持续 ROSC 率以及出院时良好神经功能结局显著更高（均<0.005）。SES 较低组与 SES 较高和中等组相比，调度员识别时间显著延长（ = 0.004），早期（≤60 s）识别率显著降低（ = 0.029）。多变量回归模型显示，SES 较高组与持续 ROSC 显著相关，但无任何 DA-CPR 措施与之相关。SES 较低组与调度员识别心脏骤停时间延长和 OHCA 结局较差相关。可以针对社区 SES 制定促进公众对心脏骤停认识的策略。
