scholarly journals Inequalities in Income and Education are Associated with Survival Differences after Out-of-hospital Cardiac Arrest: A Nationwide Observational Study

Circulation ◽  
2021 ◽  
Author(s):  
Martin Jonsson ◽  
Juho Härkönen ◽  
Petter Ljungman ◽  
Per Nordberg ◽  
Mattias Ringh ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Observational Study ◽  
Socioeconomic Factors ◽  
Educational Level ◽  
Disease Onset ◽  
Income Quintile ◽  
Individual Level ◽  
Higher Educational ◽  
Nationwide Observational Study ◽  
Hospital Cardiac Arrest

Background: Despite the acknowledged importance of socioeconomic factors as regards cardiovascular-disease onset, and survival, the relationship between individual-level socioeconomic factors and survival after out-of-hospital cardiac arrest (OHCA) is not fully established. Our aim was to investigate whether socioeconomic variables are associated with 30-day survival after OHCA. Methods: We linked data from the Swedish Registry for Cardiopulmonary Resuscitation with individual-level data on socioeconomic factors (i.e. educational level and disposable income) from Statistics Sweden. Confounding and mediating variables included demographic factors, comorbidity and Utstein resuscitation variables. Outcome was 30-day survival. Multiple modified Poisson regression was used for the main analyses. Results: A total of 31,373 OHCAs occurring in 2010-2017 were included. Crude 30-day survival rates by income quintiles were: Q1 (low) 414/6277 (6.6%), Q2=339/6276 (5.4%), Q3=423/6275 (6.7%), Q4=652/6273 (10.4%) and Q5 (high) 928/6272 (14.8%). In adjusted analysis, the chance of survival by income level followed a gradient-like increase, with a risk ratio (RR) of 1.86 (95% CI 1.65-2.09) in the highest-income quintile vs. the lowest. This association remained after adjusting for comorbidity, resuscitation factors and initial rhythm. A higher educational level was associated with improved 30-day survival, the RR associated with post-secondary education ≥ 4 years being 1.51 (95% CI 1.30-1.74). Survival disparities by income and educational level were observed in both men and women. Conclusions: In this nationwide observational study using individual-level socioeconomic data, higher income and higher educational level were associated with better 30-day survival following OHCA, in both sexes.

Therapeutic hypothermia and outcomes in paediatric out-of-hospital cardiac arrest: A nationwide observational study

Resuscitation ◽  
2016 ◽  
Vol 105 ◽  
pp. 8-15 ◽  
Author(s):  
Ikwan Chang ◽  
Young Ho Kwak ◽  
Sang Do Shin ◽  
Young Sun Ro ◽  
Eui Jung Lee ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Observational Study ◽  
Therapeutic Hypothermia ◽  
Nationwide Observational Study ◽  
Hospital Cardiac Arrest

Impact of puberty as threshold to differentiate outcome of out-of-hospital cardiac arrest care groups: a nationwide observational study in France

2021 ◽  
pp. emermed-2020-210447
Author(s):  
Elodie Privat ◽  
Valentine Baert ◽  
Joséphine Escutnaire ◽  
Cyrielle Dumont ◽  
Morgan Recher ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Observational Study ◽  
Children And Adolescents ◽  
International Guidelines ◽  
Factors Associated ◽  
Shockable Rhythm ◽  
Significant Difference ◽  
Adolescents And Adults ◽  
Nationwide Observational Study ◽  
Hospital Cardiac Arrest

BackgroundSince 2005, the international guidelines for out-of-hospital cardiac arrest (OHCA) use puberty to differentiate paediatric and adult care. This threshold is mainly relied on the more frequent respiratory aetiologies in children. Hitherto, to the best of our knowledge, no study has compared the characteristics and outcomes of non-pubescent children, adolescents and adult patients with OHCA. In this study, we intended to describe the characteristics, outcome and factors associated with survival of patients who experienced OHCA in the three groups: children, adolescents (pubescent<18 years) and adults (<65 years), to assess the pertinence of the guidelines.MethodsData from the French national cardiac arrest registry (2012–2017) were used in this nationwide observational study. Victims of OHCA who were <65 years old were included. The characteristics and outcomes of children and adolescents, and adolescents and adults were compared. Logistic regression was performed in each group to identify factors associated with survival at day 30.ResultsWe included 934 children, 433 adolescents and 26 952 adults. Respiratory aetiology was more frequent and shockable rhythm less frequent in children compared with adolescents (25.5% vs 17.2%, p=0.025 and 2.4% vs 6.8%, p<0.001, respectively). However, these differences were not observed between adolescents and adults (17.2% vs 14.1%, p=0.266 and 6.8% vs 10%, p=0.055, respectively). Between children and adolescents, and adolescents and adults, there was no significant difference in survival at day 30 (8.6%vs 9.8% and 9.8% vs 8.5%, respectively). For all groups, shockable initial rhythm was a factor of survival.ConclusionFrequency of respiratory aetiologies and shockable rhythm were common in adolescents and adults and different between children and adolescents. These results indicate that puberty as a threshold in international guidelines seems to be relevant.

scholarly journals Epidemiology and outcomes of out-of-hospital cardiac arrest in Qatar: A nationwide observational study

2016 ◽  
Vol 223 ◽  
pp. 1007-1013 ◽  
Author(s):  
Furqan B. Irfan ◽  
Zain Ali Bhutta ◽  
Maaret Castren ◽  
Lahn Straney ◽  
Therese Djarv ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Observational Study ◽  
Nationwide Observational Study ◽  
Hospital Cardiac Arrest
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