Association of dispatcher-assisted bystander cardiopulmonary resuscitation with survival outcomes after pediatric out-of-hospital cardiac arrest by community property value.

OBJECTIVE: We aimed to demonstrate the association of bystander cardiopulmonary resuscitation (BCPR) with survival outcomes after pediatric out-of-hospital cardiac arrest (OHCA) by community property value groups.

METHODS: This observational study enrolled all emergency medical services (EMS)-treated pediatric OHCAs in Korea between 2012 and 2015. Enrolled patients were divided into three groups: BCPR with dispatcher-assistance (DA), BCRP-without-DA, and no-BCPR. Patients were categorized based on tertiles for property tax per capita of community in which the cardiac arrest occurred. The endpoint was survival to discharge. To test the interactive effects between BCPR and community property value on study endpoints, a multilevel logistic regression model with an interaction term was used.

RESULTS: A total of 2020 patients were enrolled (37.0% BCPR-with-DA, 14.5% BCPR-without-DA, and 48.5% no-BCPR). BCPR-with-DA and BCPR-without-DA were more likely to have higher rates of survival to discharge compared to no-BCPR (8.6% and 13.0% vs. 3.5%; AORs (95% CIs): 2.23 (1.33-3.74) and 2.87 (1.57-5.25)). By interaction analysis with community property tax per capita, the AORs for survival in BCPR-with-DA and BCPR-without-DA groups were 2.56 (1.03-6.38) and 3.48 (1.10-10.9) for high value communities, 2.25 (0.95-5.31) and 3.76 (1.53-9.23) in middle communities, and 1.88 (0.88-3.99) and 1.54 (0.57-4.17) in low value communities (interaction, p = 0.68).

CONCLUSION: In pediatric OHCAs, BCRP was associated with improved survival outcomes. The survival benefits of BCPR did not differ significantly by community property value.