Ethnic and Neighborhood Socioeconomic Differences In Incidence and Survival From Out-Of-Hospital Cardiac Arrest In Singapore

Rakun, Annisa Dewi Utami; Allen, John C.; Shahidah, Nur; Ng, Yih Yng; Leong, Benjamin Sieu-Hon; Gan, Han Nee; Mao, Desmond Renhao; Chia, Michael Yih Chong; Cheah, Si Oon; Tham, Lai Peng; Ong, Marcus Eng Hock

doi:10.1080/10903127.2018.1558317

Cited by 17 publications

(17 citation statements)

References 32 publications

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“…At the full text screening phase, citations were excluded due to not reporting associations between SES and OHCA incidence, bystander CPR provision or survival after OHCA. Out of the included studies, twelve measured SES differences in OHCA incidence, 25,[29][30][31]35,[38][39][40][41][42]47,48 thirteen measured SES differences in bystander CPR provision for OHCA 22,23,26,28,32,34,36,37,40,44,45,48,50 and fourteen measured SES differences in survival rate after an OH-CA. 16,21,24,[26][27][28]33,39,43,45,46,[49][50][51] Descriptive characteristics are provided in Table 2.…”

Section: Resultsmentioning

confidence: 99%

Socio-economic differences in incidence, bystander cardiopulmonary resuscitation and survival from out-of-hospital cardiac arrest: A systematic review

et al. 2019

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Background: Individuals with a low socioeconomic status (SES) may have a greater mortality rate from out of hospital cardiac arrest (OHCA) than those with a high SES. We explored whether SES disparities in OHCA mortality manifest in the incidence of OHCA, the chance of receiving bystander cardiopulmonary resuscitation (CPR) or in the chance of surviving an OHCA. We also studied whether sex and age differences exist in such SES disparities. Methods:The Medline, Embase and Scopus databases were searched from 01-01-1993 until 31-01-2019. Studies utilising any study design or population were included. Studies were included if the exposure was SES of the OHCA victim or the OHCA location and the outcome was either OHCA incidence, CPR provision and/or survival rate after OHCA. Study selection and quality assessment were conducted by two reviewers independently.Descriptive data and measures of association were extracted, both in the total study population and in subgroups stratified by age and/or sex. This review was carried out following the PRISMA guidelines.Results: Overall 32 studies were included. Twelve studies reported on OHCA incidence, thirteen on bystander CPR provision and fourteen on survival. Some evidence for SES differences was found in each identified stage. In all the studies on incidence, SES was measured over the area of the OHCA victims' residence and was consistently associated with OHCA. In studies on bystander CPR, SES of the area in which the OHCA occurred was associated with bystander CPR, while evidence on individual SES was lacking. In studies on OHCA survival, SES of the victim measured at the individual level and SES of the area in which the OHCA occurred were associated, while SES of the victim, measured at the area of residence was not.Studies reporting age and sex differences in the SES trends were scarce. Conclusion:SES disparities in OHCA mortality likely manifest in OHCA incidence, bystander CPR provision and survival rate after OHCA. However, there is a distinct lack of data on SES measured at the individual level and on differences within subgroups, e.g. by sex and age.

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Section: Resultsmentioning

confidence: 99%

Socio-economic differences in incidence, bystander cardiopulmonary resuscitation and survival from out-of-hospital cardiac arrest: A systematic review

et al. 2019

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“…The annual incidence of EMS-treated OHCA per 100,000 persons ranged from 47.4 (Singapore) to 87.1 (Osaka). 9,10 The highest rate of survival to discharge and neurologic recovery was demonstrated in Seoul (9.9% and 3.7%, respectively). 8…”

Section: Study Design and Settingmentioning

confidence: 97%

“…Significant differences in the patients' characteristics and outcomes were observed based on prehospital AAM. The scene time interval was significantly longer in the AAM group than the non-AAM group (median time interval 10 minutes [IQR,[7][8][9][10][11][12][13][14] vs. 15 minutes [IQR,11-18.5]). The non-AAM group showed better neurological recovery rates than the AAM group (4.9% vs. 2.0%, P < 0.01).…”

mentioning

confidence: 99%

Variability in the effects of prehospital advanced airway management on outcomes of patients with out-of-hospital cardiac arrest

Ahn

Shin

et al. 2020

Clin Exp Emerg Med

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Objective To investigate variations in the effects of prehospital advanced airway management (AAM) on outcomes of out-of-hospital cardiac arrest (OHCA) patients according to regional emergency medical service (EMS) systems in four Asian cities. Methods We enrolled adult patients with EMS-treated OHCA of presumed cardiac origin between 2012 and 2014 from Osaka (Japan), Seoul (Republic of Korea), Singapore (Singapore), and Taipei (Taiwan). The main exposure variable was prehospital AAM. The primary endpoint was neurological recovery. We compared outcomes between the prehospital AAM and non-AAM groups using multivariable logistic regression with an interaction term between prehospital AAM and the four Asian cities. Results A total of 16,510 patients were included in the final analyses. The rates of prehospital AAM varied among Osaka, Seoul, Singapore, and Taipei (65.0%, 19.2%, 84.9%, and 34.1%, respectively). The non-AAM group showed better outcomes than the AAM group (adjusted odds ratio [aOR] for neurological recovery 0.30; 95% confidence interval [CI], 0.24-0.38]). In the interaction model for neurological recovery, the aORs for AAM in Osaka and Singapore were 0.12 (95% CI, 0.06-0.26) and 0.21 (95% CI, 0.16-0.28), respectively. In Seoul and Taipei, the association between prehospital AAM and neurological recovery was not significant (aOR 0.58 [95% CI, 0.31-1.10] and 0.79 [95% CI, 0.52-1.20], respectively). The interaction between prehospital AAM and region was significant (P = 0.01). Conclusion The effects of prehospital AAM on outcomes of OHCA patients differed according to regional variability in the EMS systems.

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“…Malays in Singapore face multiple disparities. The literature indicates that the Malay population in Singapore face health, economic, and educational disparities (Mutalib, 2012;Chua et al, 2019;Rakun et al, 2019). In terms of education, housing, and socioeconomic status (SES), there are still critical gaps faced by the Malay community compared to the rest of the population (Mathew and Lim, 2019).…”

Section: Malay Disenfrachisment and Health Disparitiesmentioning

confidence: 99%

“…Building on the medical and public health evidence regarding ethnic disparities and heart disease (e.g., Sabanayagam et al, 2013;Rakun et al, 2019), we argue for heart health can be understood through the lens of racial, economic, and health inequality, by centering the voices of those most afflicted by the heart health burden. The Malay community faces jarring heart health disparities compared to other ethnic populations in the country (Sabanayagam et al, 2009;Kaur, 2018).…”

Section: Introductionmentioning

confidence: 99%

A Community-Based Heart Health Intervention: Culture-Centered Study of Low-Income Malays and Heart Health Practices

2020

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This paper reports the formative research findings of a culture-centered heart health intervention with Malay community members belonging to low-income households. The community-based culture-centered intervention entailed working in the grassroots with community stakeholders to tailor a heart health campaign with and for low-income Malay Singaporeans. Community stakeholders designed and developed the heart health communicative infrastructures during six focus group sessions detailed in the results. The intervention included building smoking cessation information accessible to the community, the curation of heart healthy Malay centric recipes, and developing culturally responsive information infrastructures to understand a myocardial infarction. The intervention sought to bridge the gap for the community where there is an absence of culturally-centered communicative infrastructures on heart health.

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Ethnic and Neighborhood Socioeconomic Differences In Incidence and Survival From Out-Of-Hospital Cardiac Arrest In Singapore

Cited by 17 publications

References 32 publications

Socio-economic differences in incidence, bystander cardiopulmonary resuscitation and survival from out-of-hospital cardiac arrest: A systematic review

Socio-economic differences in incidence, bystander cardiopulmonary resuscitation and survival from out-of-hospital cardiac arrest: A systematic review

Variability in the effects of prehospital advanced airway management on outcomes of patients with out-of-hospital cardiac arrest

A Community-Based Heart Health Intervention: Culture-Centered Study of Low-Income Malays and Heart Health Practices

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