Related Experiment Video
Updated: Jun 4, 2025
05:36
Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine
Published on: January 30, 2020
7.6K
Rural Out-of-Hospital Cardiac Arrest Patients More Likely to Receive Bystander CPR: A Retrospective Cohort Study
James Hart1, J Priyanka Vakkalanka2,3, Uche Okoro4
1Mid America Emergency Physicians, Springfield, Illinois.
Prehospital Emergency Care
|December 17, 2024
Summary
Survival from out-of-hospital cardiac arrests (OHCA) is lower in rural areas, necessitating increased bystander intervention. This study found bystander CPR rates were higher in rural towns but lower in communities with less education and higher non-Caucasian or older populations.
Area of Science:
- Emergency Medicine
- Public Health
- Sociology
Background:
- Survival rates for out-of-hospital cardiac arrests (OHCA) are disproportionately lower in rural regions.
- Extended Emergency Medical Services (EMS) response times in rural areas highlight the critical role of immediate bystander intervention, including Cardiopulmonary Resuscitation (CPR).
Purpose of the Study:
- To compare the incidence of bystander CPR in rural versus urban settings.
- To identify societal factors associated with the prevalence of bystander CPR during OHCA events.
Main Methods:
- A retrospective cohort study utilized county-level data from the National Emergency Medical Services Information System (NEMSIS), American Community Survey, and Bureau of Health Care Workforce (2019-2020).
- Outcomes for adult OHCA patients treated by EMS were analyzed, with rurality defined by Rural Urban Commuting Area codes.
- Generalized estimating equations were employed to assess the association between patient and community factors and bystander CPR, adjusting for clustering at the county level.
Main Results:
- Out of 99,171 OHCA cases, 60.9% received bystander CPR.
- Patients in isolated small rural towns demonstrated a higher likelihood of receiving bystander CPR (aOR: 1.57) compared to those in urban cities.
- Bystander CPR rates were significantly lower in counties with higher proportions of individuals lacking high school diplomas (aOR: 0.56), non-Caucasian populations (aOR: 0.83), and older individuals (aOR: 0.82).
Conclusions:
- Lower rates of bystander CPR were observed in communities characterized by lower educational attainment, higher non-Caucasian demographics, and older populations.
- Public health initiatives promoting bystander CPR training are essential, particularly in rural areas with longer EMS response times, to address disparities linked to diverse community characteristics.
