Abstract 142: Community-wide Bystander-focused Interventions And Sex Disparities In The Receipt Of Bystander Cardiopulmonary Resuscitation In Public

Introduction: Female sex is associated with lower receipt of bystander cardiopulmonary resuscitation (BCPR) in public. Telephone-assisted CPR (TCPR) may attenuate this known sex difference. It is unknown whether the introduction of community-wide, bystander-focused interventions may reduce this known sex difference and improve outcomes for females. Objectives: We sought to assess whether implementation of bystander-focused, out-of-hospital cardiac arrest (OHCA) interventions attenuated the sex difference seen in receipt of BCPR. We hypothesized that implementation of bystander-focused interventions would reduce the known difference observed in males compared to females in receipt of BCPR in public. Methods: We conducted a retrospective study of adult, non-traumatic OHCAs from the Singapore OHCA registry (1/2011-12/2020). Bystander-focused interventions included TCPR (7/2012 - present), CPR/AED training (04/2014 - present), and myResponder (4/2015 - present). We examined the differences between males vs females in receipt of BCPR in public using descriptive statistics, a sex-intervention interaction term, and hierarchical regression modeling. Results: The registry contained 19,321 events (2011-2020). Excluding pediatric, traumatic, EMS witnessed, and healthcare facility arrests, 18,925 events were analyzed. Of these, mean age was 68±16 and 64% were male. BCPR was administered in 56% of the events, with 61% of males and 54% of females receiving BCPR in public (p-value <0.01). Females had a 29% decreased odds of receiving BCPR compared to males in public (OR: 0.72 (95% CI: 0.58-0.90), p-value <0.01). With inclusion of implementation of bystander-focused interventions as an interaction term with sex, the difference in receipt of BCPR between males and females was no longer observed (p-value: ns). The sex-intervention interaction term was statistically significant (p-value<0.01). No sex differences were observed when modelling survival as an outcome. Conclusion: The introduction of community-wide, bystander-focused interventions may lessen differences seen in receipt of BCPR by males and females in public. Further research on OHCA interventions is needed to increase provision of BCPR and consider addressing this disparity.