Individual-level income and out-of-hospital cardiac arrest survival in men and women

Abstract

ObjectiveArea-level socioeconomic factors are known to associate with chances to survive out-of-hospital cardiac arrest (OHCA survival). However, the relationship between individual-level socioeconomic factors and OHCA survival in men and women is less established. This study investigated the association between individual-level income and OHCA survival in men and women, as well as its contribution to outcome variability and mediation by resuscitation characteristics.MethodsA cross-sectional cohort study using data from a Dutch community-based OHCA registry was performed. We included 5395 patients aged≥25 years with OHCA from a presumed cardiac cause. Household income, derived from Statistics Netherlands, was stratified into quartiles. The association between survival to hospital discharge and household income was analysed using multivariable logistic regression adjusting for age, sex and resuscitation characteristics.ResultsOverall women had lower household income than men (median €18 567 vs €21 015), and less favourable resuscitation characteristics. Increasing household income was associated with increased OHCA survival in both men and women in a linear manner (Q4 vs Q1: OR 1.63 95% CI (1.24 to 2.16) in men, and 2.54 (1.43 to 4.48) in women). Only initial rhythm significantly changed the ORs for OHCA survival with>10% in both men and women. Household income explained 3.8% in men and 4.3% in women of the observed variance in OHCA survival.ConclusionBoth in men and women, higher individual-level household income was associated with a 1.2-fold to 2.5-fold increased OHCA survival to hospital discharge, but explained only little of outcome variability. A shockable initial rhythm was the most important resuscitation parameter mediating this association. Our results do not support the need for immediate targeted interventions on actionable prehospital resuscitation care characteristics.

Evaluation of Socioeconomic Position and Survival After Out-of-Hospital Cardiac Arrest in Korea Using Structural Equation Modeling

“…The initial rhythm on the electrocardiogram was found to be an important mediator of the SEP-OHCA survival association. Previous studies have suggested that favorable resuscitation characteristics, including witnessed arrest and shorter response time, are associated with initial shockable rhythm . Differences in the etiology of cardiogenic cardiac arrest and disparities in the no-flow time to recognition of OHCA may have also contributed to the association between SEP and initial rhythm.…”

“…Socioeconomic Position and Survival After Out-of-Hospital Cardiac Arrest in Korea characteristics, including witnessed arrest and shorter response time, are associated with initial shockable rhythm. 20,32 Differences in the etiology of cardiogenic cardiac arrest and disparities in the no-flow time to recognition of OHCA may have also contributed to the association between SEP and initial rhythm. Although the initial rhythm is not directly modifiable, interventions to reduce disparities in witnessed status, bystander CPR provision, and no-flow time may be effective.…”

Nigerian Athletes’ Previous Training, Practice and Current Knowledge of Bystander Cardiopulmonary Resuscitation

“…There is limited literature available on bystander CPR among Nigerian athletes [31,32]. Meanwhile, it has been documented that developing economies could be burdened by sudden cardiac death (SCD) as much as in the developed parts of the globe [33][34][35][36][37]. In fact, the study by Chen et al [33], which is the largest study showing an association between socioeconomic status and survival, and the first study showing an association with bystander CPR, suggested targeting CPR training among the lower socioeconomic groups.…”