title: Disparities in bystander CPR provision and survival from out-of-hospital cardiac arrest according to neighborhood ethnicity.
abstract: OBJECTIVE
  We aimed to determine if there are differences in bystander cardiopulmonary resuscitation (BCPR) provision and survival to hospital discharge from out-of-hospital cardiac arrest (OHCA) occurring in Hispanic neighborhoods in Arizona.
  
  
  METHODS
  We analyzed a prospectively collected, statewide Utstein-compliant OHCA database between January 1, 2010, and December 31, 2012. Cases of OHCA were geocoded to determine their census tract of event location, and their neighborhood main ethnicity was assigned using census data. Neighborhoods were classified as "Hispanic" or "non-Hispanic white" when the percentage of residents in the census tract was 80% or more.
  
  
  RESULTS
  Among the 6637 geocoded adult OHCA victims during the study period, 4821 cases were included in this analysis, after excluding 1816 cases due to incident location, traumatic cause, or because the arrest occurred after emergency medical service arrival. In OHCAs occurring at Hispanic neighborhoods as compared with non-Hispanic white neighborhoods, the provision of BCPR (28.6% vs 43.8%; P < .001) and initially monitored shockable rhythm (17.3% vs 25.7%; P < .006) was significantly less frequent. Survival to hospital discharge was significantly lower in Hispanic neighborhoods than in non-Hispanic white neighborhoods (4.9% vs 10.8%; P = .013). The adjusted odds ratio (OR) of Hispanic neighborhood for BCPR provision (OR, 0.62; 95% confidence interval, 0.44-0.89) was lower as compared with non-Hispanic white neighborhoods.
  
  
  CONCLUSIONS
  In Arizona, OHCA patients in Hispanic neighborhoods received BCPR less frequently and had a lower survival to hospital discharge rate than those in non-Hispanic white neighborhoods. Public health efforts to attenuate this disparity are needed.
authors: Arizona Department of Health Services Bureau of Emergency Medical Services and Trauma System, Phoenix, AZ; Arizona Emergency Medicine Research Center, University of Arizona College of Medicine, Tucson, AZ; Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggido, Korea. Electronic address: sungwoo.moon89@gmail.com.
authors: Sungwoo
authors: S
authors: Moon
authors: Arizona Department of Health Services Bureau of Emergency Medical Services and Trauma System, Phoenix, AZ; Arizona Emergency Medicine Research Center, University of Arizona College of Medicine, Tucson, AZ; Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ.
authors: Bentley J
authors: BJ
authors: Bobrow
authors: Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL.
authors: Tyler F
authors: TF
authors: Vadeboncoeur
authors: Arizona Department of Health Services Bureau of Public Health Statistics, Phoenix, AZ.
authors: Wesley
authors: W
authors: Kortuem
authors: Arizona Department of Health Services Bureau of Public Health Statistics, Phoenix, AZ.
authors: Marvis
authors: M
authors: Kisakye
authors: Department of Emergency Medicine, University of Colorado School of Medicine, Denver, CO.
authors: Comilla
authors: C
authors: Sasson
authors: Arizona Emergency Medicine Research Center, University of Arizona College of Medicine, Tucson, AZ.
authors: Uwe
authors: U
authors: Stolz
authors: Arizona Emergency Medicine Research Center, University of Arizona College of Medicine, Tucson, AZ.
authors: Daniel W
authors: DW
authors: Spaite
mesh_terms: D000368:Aged; D001130:Arizona / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000208:ethnology / Q000401:mortality / Q000628:therapy*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D016019:Survival Analysis; D044465:White People / Q000706:statistics & numerical data