title: Impact of neighbourhood socio-economic status on bystander cardiopulmonary resuscitation in Paris.
abstract: No European data currently describe the relation between neighbourhood socio-economic status (SES) and rates of out-of-hospital cardiac arrest (OHCA) bystander cardiopulmonary resuscitation (CPR). This study aims to analyse this effect with a robust deprivation index.
  
  
  
  Data about all OHCA in Paris were collected prospectively between 2000 and 2010. A geographical neighbourhood unit was assigned to each case. Median household income, and rates of blue-collar workers, unemployment, and adults without high school diplomas were selected as SES characteristics and used to classify neighbourhoods as low SES or higher SES. We analysed the relationship between neighbourhood SES characteristics and the probability of receiving bystander CPR.
  
  
  
  Of the 4009 OHCA with mappable addresses recorded, 777 (19.4%) received bystander CPR. Compared to OHCA who did not receive bystander CPR, those receiving CPR were significantly more likely to have occurred in public locations, have had a witness to their OHCA, and not to have collapsed in a low SES neighbourhood, or in a neighbourhood with a median household income in the lowest quartile and with rates of no high school diplomas and blue-collar workers in the highest quartile. In the multilevel analyses, bystander CPR provision was significantly less frequent in low than in higher SES neighbourhoods (OR 0.85; 95% confidence interval [CI] 0.72-0.99).
  
  
  
  In the city of Paris, OHCA victims were less likely to receive bystander CPR in low SES neighbourhoods. These first European data are consistent with observations in North America and Asia.
authors.affiliation: Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France; AP-HP, SMUR, Hôpital Lariboisière, Paris, France; Université Paris Descartes-Paris V, Paris, France. Electronic address: benjamin.dahan@inserm.fr.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Dahan
authors.affiliation: Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France; AP-HP, Samu de Paris, Hôpital Necker-Enfants Malades, Paris, France.
authors.forename: Patricia
authors.initials: P
authors.lastname: Jabre
authors.affiliation: Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France; AP-HP, Service de Cardiologie, Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: Nicole
authors.initials: N
authors.lastname: Karam
authors.affiliation: Université de Rouen, Laboratoire IDEES, UMR CNRS 6266 IDEES, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: Misslin
authors.affiliation: Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Tafflet
authors.affiliation: Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France; AP-HP, Service de Cardiologie, Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: Wulfran
authors.initials: W
authors.lastname: Bougouin
authors.affiliation: Brigade des Sapeurs-Pompiers de Paris, Paris, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Jost
authors.affiliation: Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France.
authors.forename: Frankie
authors.initials: F
authors.lastname: Beganton
authors.affiliation: Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France; Université Paris Descartes-Paris V, Paris, France; AP-HP, Service de Cardiologie, Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: Eloi
authors.initials: E
authors.lastname: Marijon
authors.affiliation: Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France; Université Paris Descartes-Paris V, Paris, France; AP-HP, Service de Cardiologie, Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Jouven
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D005392:First Aid / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D006379:Helping Behavior; D006801:Humans; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology / Q000628:therapy; D010297:Paris / Q000453:epidemiology; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012923:Social Class
keywords: Cardiac arrest; Cardiopulmonary resuscitation; Epidemiology; Socio-economic status