Article Text
Abstract
Background Rates of out-of-hospital cardiac arrest (OHCA) and bystander cardiopulmonary resuscitation (CPR) have been shown to vary considerably in Victoria. We examined the extent to which this variation could be explained by the sociodemographic and population health characteristics of the region.
Methods Using the Victorian Ambulance Cardiac Arrest Registry, we extracted OHCA cases occurring between 2011 and 2013. We restricted the calculation of bystander CPR rates to those arrests that were witnessed by a bystander. To estimate the level of variation between Victorian local government areas (LGAs), we used a two-stage modelling approach using random-effects modelling.
Results Between 2011 and 2013, there were 15 830 adult OHCA in Victoria. Incidence rates varied across the state between 41.9 to 104.0 cases/100 000 population. The proportion of the population over 65, socioeconomic status, smoking prevalence and education level were significant predictors of incidence in the multivariable model, explaining 93.9% of the variation in incidence among LGAs. Estimates of bystander CPR rates for bystander witnessed arrests varied from 62.7% to 73.2%. Only population density was a significant predictor of rates in a multivariable model, explaining 73% of the variation in the odds of receiving bystander CPR among LGAs.
Conclusions Our results show that the regional characteristics which underlie the variation seen in rates of bystander CPR may be region specific and may require study in smaller areas. However, characteristics associated with high incidence and low bystander CPR rates can be identified and will help to target regions and inform local interventions to increase bystander CPR rates.
- EPIDEMIOLOGY
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Contributors LDS prepared the analysis plan, undertook the statistical analysis, as well as drafted and revised the paper. JEB devised the study design, reviewed the analysis, as well as drafted and revised the paper. BB prepared and analysed the data, and revised the draft paper. SB reviewed the analysis and revised the draft paper. ML reviewed the analysis, and drafted and revised the paper. KS initiated the study, reviewed the analysis, as well as drafted and revised the paper.
Funding JEB and LDS receive salary support from the National Medical Health and Research Council (NHMRC) funded Australian Resuscitation Outcomes Consortium (#1029983) Centre of Research Excellence. JEB receives salary support from an NHMRC/National Heart Foundation Public Health Fellowship (#1069985).
Competing interests None declared.
Ethics approval Monash University Human Research Ethics Committee (CF12/3410–2 012001638).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement These data were sourced from a third party as the data are maintained in an ongoing registry at Ambulance Victoria. The registry contains potentially identifiable information and thus data requests and extracts are performed with regard to the needs of individual projects to maintain confidentiality. The data used in this study are available on request to KS at Ambulance Victoria (karen.smith@ambulance.vic.gov.au).