Evidence map›Paper›PMID 38851447›Full record

ArticleResuscitation2024

Historical neighborhood redlining and bystander CPR disparities in out-of-hospital cardiac arrest.

Issam Motairek, Pedro Rvo Salerno, Zhuo Chen, Salil Deo, Mohamed H E Makhlouf, Rabab Al-Araji, Sanjay Rajagopalan, Khurram Nasir, Sadeer Al-Kindi, CARES Surveillance Group

Abstract read
In one paragraph

Article in Resuscitation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Closing the Gap: Addressing Racial Bias in Bystander CPR Administration.Inquiry : a journal of medical care organization, provision and financing
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Issam MotairekDepartment of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States; Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.
Pedro Rvo SalernoHarrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.
Zhuo ChenHarrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.
Salil DeoHarrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States; Surgical Services, Louis Stokes VA Medical Center, Cleveland, OH, United States; Case Western Reserve University School of Medicine, Cleveland, OH, United States.
Mohamed H E MakhloufHarrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.
Rabab Al-ArajiDepartment of Global Health, Emory University, Atlanta, GA, United States.
Sanjay RajagopalanHarrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States; Case Western Reserve University School of Medicine, Cleveland, OH, United States.
Khurram NasirHouston Methodist Hospital, Houston, TX, United States.
Sadeer Al-KindiHouston Methodist Hospital, Houston, TX, United States. Electronic address: sal-kindi@houstonmethodist.org.
CARES Surveillance Group

Funding

ACHIEVE P3 - CHDP50MD017351 · NIMHD · WAYNE STATE UNIVERSITY · PI DAILEY, RHONDA K · 2021 to 2025
$21.1M
Diversity Suppplement (CIRCADIAN) Circadian Disruption as Mediator of Cardiometabolic Risk in Air PollutionR35ES031702 · NIEHS · CASE WESTERN RESERVE UNIVERSITY · PI Sanjay Rajagopalan · 2021 to 2026
$5.9M
NIEHS NIH HHS R35 ES031702NIMHD NIH HHS P50 MD017351
6 · The paper itself

Abstract

backgroundOut-of-hospital cardiac arrest (OHCA) is associated with low survival rates. Bystander cardiopulmonary resuscitation (CPR) is essential for improving outcomes, but its utilization remains limited, particularly among racial and ethnic minorities. Historical redlining, a practice that classified neighborhoods for mortgage risk in 1930s, may have lasting implications for social and health outcomes. This study sought to investigate the influence of redlining on the provision of bystander CPR during witnessed OHCA.

methodsWe conducted an analysis using data from the comprehensive Cardiac Arrest Registry to Enhance Survival (CARES), encompassing 736,066 non-traumatic OHCA cases across the United States. The Home Owners' Loan Corporation (HOLC) map shapefiles were utilized to categorize census tracts of arrests into four grades (A signifying "best", B "still desirable", C "declining", and D "hazardous"). Multivariable hierarchical logistic regression models were employed to predict the likelihood of CPR provision, adjusting for various factors including age, sex, race/ethnicity, arrest location, calendar year, and state of occurrence. Additionally, we accounted for the percentage of Black residents and residents below poverty levels at the census tract level.

resultsAmong the 43,186 witnessed cases of OHCA in graded HOLC census tracts, 37.2% received bystander CPR. The rates of bystander CPR exhibited a gradual decline across HOLC grades, ranging from 41.8% in HOLC grade A to 35.8% in HOLC grade D. In fully adjusted model, we observed significantly lower odds of receiving bystander CPR in HOLC grades C (OR 0.89, 95% CI 0.81-0.98, p = 0.016) and D (OR 0.86, 95% CI 0.78-0.95, p = 0.002) compared to HOLC grade A.

conclusionRedlining, a historical segregation practice, is associated with reduced contemporary rates of bystander CPR during OHCA. Targeted CPR training in redlined neighborhoods may be imperative to enhance survival outcomes.

Indexed as

Cardiopulmonary ResuscitationOut-of-Hospital Cardiac ArrestAgedEmergency Medical ServicesFemaleHealthcare DisparitiesHumansMaleMiddle AgedNeighborhood CharacteristicsRegistriesResidence CharacteristicsUnited StatesBystander Cardiopulmonary ResuscitationCardiac Arrest Registry to Enhance SurvivalOut-of-hospital cardiac arrestRacial Disparities

Identifiers

PMID38851447
PMCPMC12046434

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.