39 Bystander CPR in out-of-hospital cardiac arrest in singapore: age and other predictive factors

Abstract

Aim

Multiple studies affirm that Bystander CPR (BCPR) improves outcomes in Out-of-hospital Cardiac Arrest (OHCA). This study investigates age and other factors in affecting BCPR rates in Singapore.

Method

Data was extracted from the national cardiac arrest registry. OHCA cases in Singapore conveyed via emergency medical services from April 2010–December 2015 were included. Zipcodes of arrest location, census data from 2010–2015 and planning areas were used for geospatial analysis. Multivariate logistic regression was performed to investigate the association between patient demographics and pre-hospital data with BCPR.

Results

8955 cases were split into 3 groups: Paediatric (Age 0–10 years; n=107), Young (Age 11–65 years; n=3979), Old (Age>65 years; n=4869). Compared to the Old, Paediatric and Young patients had higher rates of BCPR (OR 3.997, 95% CI: 2.567 to 6.224; OR 1.133, 95% CI: 1.027 to 1.249). Non-traumatic arrest (OR 2.550, 95% CI: 1.743 to 3.731) and Witnessed arrest (OR 1.267, 95% CI: 1.157 to 1.387), positively associated with BCPR, while arrest in residential location (OR 0.655, 95% CI: 0.441 to 0.973) negatively associated with BCPR. Of the OHCA in residential locations, patients in neighbourhoods with younger population were more likely to receive BCPR (OR 1.242, 95% CI: 1.061 to 1.453) compared to older neighbourhoods. There was no association with gender and major race groups, and univariate analysis showed no difference in BCPR rates between family bystanders and other layperson bystanders.

Conclusion

Older patients, residential arrests and older neighbourhoods were associated with lower rates of BCPR. Public education and training programs can be targeted to these populations to improve BCPR rates.

Conflict of interest

None

Funding

This study was supported by grants from National Medical Research Council, Clinician Scientist Award, Singapore (NMRC/CSA/024/2010 and NMRC/CSA/0049/2013), Ministry of Health, Health Services Research Grant, Singapore (HSRG/0021/2012) and Duke-NUS Khoo Research Student Award (Duke-NUS-KRSA/2013/0001).