Where you live matters: socioeconomic disparities in out-of-hospital cardiac arrest incidence and survival in Western Australia - A population-based cohort study

居住地至关重要:西澳大利亚院外心脏骤停发生率和生存率的社会经济差异——一项基于人群的队列研究

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Abstract

AIMS: Investigate socioeconomic differences in the incidence and odds of survival of adult out-of-hospital cardiac arrests [OHCA] in Western Australia [WA]. METHODS: OHCA data for patients aged 15 years and older were sourced for the period 2015-2024 for WA. Socioeconomic status was classified using the Australian Bureau of Statistics Index of Relative Socio-Economic Disadvantage. Socioeconomic status was attributed based on each patient's residential address and classified in quintiles. Crude and age-standardised incidence rates per 100,000 adult population was calculated for all OHCA. Survival (return of spontaneous circulation at hospital arrival and survival to 30-days) was assessed for resuscitation-attempted OHCA with medical aetiology. Incidence by socioeconomic quintile was modelled using negative binomial linear regression, and odds of survival by socioeconomic quintile using logistic regression. RESULTS: A total of 23,975 OHCAs were attended by emergency medical services in WA, with a crude incidence of 117.34 per 100,000 population per year. Outcomes varied across the socioeconomic gradient, with higher incidence and poorer survival in more disadvantaged populations. Incidence decreased from 193.81/100,000 in the most disadvantaged quintile to 73.18/100,000 in the least disadvantaged quintile (p < 0.001). Among resuscitation-attempted medical OHCA, patients in the least disadvantage areas had 67% greater odds of 30-day survival than those in the most disadvantaged areas (OR: 1.67; 95%CI: 1.28-2.18). CONCLUSION: Greater socioeconomic disadvantage is associated with a greater incidence of OHCA and poorer survival outcomes.

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