Health systems developments and predictors of bystander CPR in Ireland

Area of Science:

• Public Health
• Emergency Medicine
• Cardiology

Background:

• Out-of-hospital cardiac arrest (OHCA) survival is significantly improved by immediate bystander cardiopulmonary resuscitation (CPR).
• Understanding factors influencing bystander CPR provision is crucial for optimizing emergency response systems.

Purpose of the Study:

• To identify predictors of bystander CPR in Ireland between 2012 and 2020.
• To analyze the relationship between bystander CPR and health system developments during this period.

Main Methods:

• Analysis of national OHCA registry data for witnessed and unwitnessed arrests.
• Logistic regression modeling with stepwise variable selection and interaction analysis.
• Multiple imputation was used for missing data sensitivity analyses.

Main Results:

• Bystander CPR was performed in 77% of 18,177 OHCA resuscitation attempts.
• Factors associated with increased bystander CPR included increasing year, longer call response intervals.
• Factors associated with decreased bystander CPR included COVID-19 period, older age, and urban location.

Conclusions:

• Bystander CPR rates in Ireland showed a positive trend, likely influenced by health system developments, though COVID-19 posed a disruption.
• Urban OHCA locations demonstrated significantly lower rates of bystander CPR compared to rural areas.
• Interventions to increase bystander CPR in urban settings are urgently needed.