Bystander Interventions and Survival After Out-of-Hospital Cardiac Arrest According to Neighborhood Ethnicity

AIMS: Studies from the United States show less bystander resuscitation in predominantly non-white neighborhoods. Given Europe's ethnic diversity, we aimed to investigate out-of-hospital cardiac arrest (OHCA) outcomes according to neighborhood ethnicity to guide future educational efforts.

METHODS: Using the Danish Cardiac Arrest Registry and grid cells from the Danish Grid System, 2016-2021 OHCAs were geocoded and grouped into non-Western neighborhoods (≥50% non-Western origin residents), Danish neighborhoods (≥50% Danish origin residents), and mixed population neighborhoods (remaining neighborhoods).A logistic regression model was used to adjust for patient sex, age, and area-level household income to compare outcomes.

RESULTS: Overall, 12,750 OHCAs were included: 483 (3.8 %) occurred in non-Western, 12,100 (96.1%) in Danish, and 167 (1.4%) in mixed population neighborhoods. Of 78,214 grid cells, 1,556 (2.0%) were non-Western 76,039 (97.2%) were Danish, and 625 (0.8%) were mixed population neighborhoods. OHCA/km2/year incidence was 5.17 in non-Western, 2.65 in Danish, and 4.46 in mixed population neighborhoods. Compared to Danish neighborhoods, OHCA patients in non-Western neighborhoods had significantly lower odds of receiving bystander cardiopulmonary resuscitation (CPR) (odds ratio [OR]: 0.71, 95% confidence interval [CI]: 0.58-0.87) and defibrillation (OR: 0.64, 95% CI: 0.42-0.97). There was no significant difference in bystander CPR (OR: 0.64, 95% CI: 0.42-1.23) and defibrillation (OR: 1.17, 95% CI: 0.68-2.00) between mixed population and Danish neighborhoods.

CONCLUSION: Individuals who experienced OHCA in predominantly non-Western neighborhoods received less bystander CPR and defibrillation compared to Danish neighborhoods. Targeted and tailored interventions may help improve resuscitation disparities in these areas.