Bystander CPR Rate for out-of-hospital sudden cardiac arrest

Out-of-hospital sudden cardiac arrest is a major cause of mortality, claiming approximately 300,000 lives each year in the US.  Survival rates are approximately 8% nationwide, but successful resuscitation is possible. Bystander CPR is key as the chances of survival decrease by up to 10% for every minute that elapses until CPR is started. 

Linkage between multi-state population-based Cardiac Arrest Registry to Enhance Survival (CARES) and county-based census information provides an opportunity to evaluate if and how bystander CPR varies by demographics.   We hypothesized that higher income will translate into higher rates of bystander CPR being performed in those counties.

A cohort study of treated out-of-hospital cardiac arrests was conducted.  We investigated bystander CPR rates according to a county’s median income, educational attainment and median age.  We used descriptive statistics to determine if counties with higher education, greater median income or greater median age were associated with a greater likelihood of bystander CPR.

There were 22,315 arrests among the 161 participating counties and agencies participating in the Heart Rescue Program.  Overall, bystander CPR was 41.2%. Bystander CPR (34.1%) was lowest in counties with the lowest quartile and highest (46.0%) in the second quartile of median income (p<0.05).  Bystander CPR rate was lowest for counties in the lowest educational attainment quartile (34.8%) and for counties in the third quartile (35.9%) when compared to the second and fourth quartile counties (p<0.05).  Bystander CPR rate was lowest for counties in the second quartile of median age and higher for other quartiles (p<0.05).