CPR less likely to be used on black children vs. white children from poor areas
Black children from disadvantaged neighborhoods were approximately half as likely to receive bystander CPR compared with white children, researchers reported.
“When analyzing the epidemiology of bystander CPR in children in the United States [in 2017], we found lower bystander CPR rates in black and Hispanic children compared to white children, but weren’t sure if this was due entirely to racial disparities or if it was also associated with neighborhood socioeconomic factors like income, employment and educational status,” Maryam Y. Naim, MD, a pediatric cardiac intensive care physician at Children’s Hospital of Philadelphia, said in a press release. “As most bystander CPR is provided by family members, lower response rates are likely due to a lack of CPR training and recognition of cardiac arrests.”
Naim and colleagues analyzed 7,086 pediatric patients (61% infants; 60% boys; 31% black; 31% white; 11% Hispanic; 3% other races; 24% unknown race) from the CARES registry with out-of-hospital cardiac arrest between 2013 and 2017.
The researchers created an index from 0 to 4 of neighborhood characteristics, with 1 point each given for more than 80% black residents, more than 10% unemployment, less than 80% with at least a high school education and less than $50,000 median income.
The primary outcome was bystander CPR, which occurred in 48% of patients.
Compared with white patients, bystander CPR was less likely in black patients (adjusted OR = 0.59; 95% CI, 0.52-0.68), Hispanic patients (aOR = 0.78; 95% CI, 0.66-0.94) and patients of other races (aOR = 0.54; 95% CI, 0.4-0.72), according to the researchers.
In addition, compared with events that occurred in neighborhoods with a score of 0, bystander CPR was less common for events occurring in neighborhoods with a score of 1 (aOR = 0.8; 95% CI, 0.7-0.91), 2 (aOR = 0.75; 95% CI, 0.65-0.86), 3 (aOR = 0.52; 95% CI, 0.45-0.61) and 4 (aOR = 0.46; 95% CI, 0.36-0.59), Naim and colleagues wrote.
With increasing neighborhood index score, black children were less likely to receive bystander CPR, but the trend was not observed with white children, according to the researchers.
Black children from neighborhoods with a score of 4 were approximately half as likely to receive bystander CPR as white children from neighborhoods with a score of 0, the researchers found.
“We believe this is the first study to describe the possible role of racial and sociodemographic factors in provision of bystander CPR to pediatric cardiac arrest in the United States,” Naim said in the release. – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.