CPR education in social housing may improve survival from cardiac arrest

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DALLAS, October 31, 2022 – Of all out-of-hospital cardiac arrests in residential areas of Vienna and Copenhagen from 2016 to 2021, one-third of those cardiac arrests occurred in public housing. This occurrence jumped to more than 60% when including the areas surrounding public housing communication, suggesting that cardiopulmonary resuscitation (CPR) education programs tailored to these communities could be an effective strategy to train more people to save lives, according to preliminary research to be presented at the 2022 American Heart Association Resuscitation Science Symposium. The 2022 meeting will be held in person in Chicago, November 5-6, 2022, and will showcase the most recent advances related to the treatment of cardiorespiratory arrests and life-threatening traumatic injuries.

“Our findings hold great potential for improving bystander CPR and survival at scale. Public housing communities are geographically well-defined areas with an organizational unit that allows feasible access to target initiatives to train the population and to deploy automated external defibrillators (AEDs),” said study lead author Anne Juul Grabmayr, MD, Ph.D. student and clinical research assistant at Copenhagen Emergency Medical Services at the University of Copenhagen in Denmark “By focusing initiatives on people living in social housing, half of all cardiac arrests can be achieved through improved AED deployment and resident CPR training.”

An AED is a lightweight, portable device that can detect an abnormal heart rhythm requiring shock treatment and delivers a shock to bring the heart rhythm back to normal.

The study compared out-of-hospital cardiac arrests in social housing communities in Vienna, Austria, from 2017 to 2021, and Copenhagen, Denmark, from 2016 to 2020 to other residential areas in each city. Researchers looked at information from city cardiac arrest registries, public housing data and an atlas for population density and residential details. which aligns with support from the American Heart Association to improve the health of people living in public housing,

Of more than 4,300 out-of-hospital residential cardiac arrests in Vienna, 32% occurred among residents of a public housing community. Of more than 2,300 out-of-hospital residential cardiac arrests in Copenhagen, 35% occurred in people who lived in a public housing community. These results represent a three-fold increase per square kilometer and a one-and-a-half-fold increase per 100,000 population compared to other residential areas. Including the immediate surroundings of all residential areas, approximately 65% ​​of all out-of-hospital cardiac arrests in Vienna occurred in public housing or within 104 meters of public housing and more than 56% occurred in the same department in Copenhagen.

“What’s unique about this study is that it explains how to find high-risk residential areas, and importantly, it also provides a point of intervention,” Grabmayr said. “Public housing communities have employees, organizations, a dedicated budget, and communication channels that may be able to help spread information about CPR, recruit people to receive CPR training, and provide and maintain AEDs.”

Social housing strategies can also help counter social inequalities, she noted, because people who live in social housing may have high rates of other illnesses. Communities may be able to serve as a base for health programs to reach at-risk populations and increase access to health care services. For example, public housing communities and other low-income housing types may be feasible targets for interventions to improve the management of hypertension or type 2 diabetes. These types of strategies align with support from the American Heart Association to improve the health of people living in public housing.

Previous research found that, compared to people who suffered cardiac arrest in remnant residential areas, those who suffered cardiac arrest in a public housing neighborhood were younger and less likely to survive. The researchers said this discrepancy in age and survival was surprising, along with the large proportion of cardiac arrests that occurred in public housing communities.

The study’s findings may apply to public housing communities in other countries, including the United States.

“We believe that a substantial proportion of cardiac arrests occur in public housing neighborhoods in communities around the world, although the proportion may not be exactly the same,” Grabmayr said. “We believe a greater proportion of residents live in public housing in communities of lower socio-economic status. Given that we suspect that these results are a marker of low socioeconomic status among residents, the results of our study may very well be transferable to the United States. Denmark and Austria are also known to have fairly low levels of health inequality, giving us reason to I think the incidence of cardiac arrest in public housing and other forms of housing may be even higher in other countries such as the United States where health care is not free or available to all.

Differences in how each country defines public housing and overall housing proportions may also limit the applicability of the study’s findings in other communities, she said.

Co-authors are Julie S. Kjoelbye, MD; Mads Christian Tofte Gregers, MD; Louise K. Jakobsen, MD; Astrid Rolin Kragh; Florian Ettl, MD; Konstantin Krychtiuk, MD, Ph.D.; Patrick Sulzgruber, MD, Ph.D.; Mario Krammel, MD; Christian Torp-Pedersen, MD, DMSc.; Annette Kjær Ersbøll, Ph.D.; Fredrik Folke, MD, Ph.D.; and Carolina Malta Hansen, MD, Ph.D. Author disclosures are listed in the abstract.

The study was funded by TrygFonden, a Danish foundation.

Statements and conclusions of studies that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the policy or position of the Association. The Association makes no representations or warranties as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, but rather by independent review committees and are considered based on the potential to add to the diversity of scientific issues and viewpoints discussed. during a meeting. Results are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

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