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Association between deprivation status at community level and outcomes from out-of-hospital cardiac arrest: a nationwide observational study |
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| Authors: | Ahn Ki Ok Shin Sang Do Hwang Seung Sik Oh Juhwan Kawachi Ichiro Kim Young Taek Kong Kyoung Ae Hong Sung Ok |
| Institution: | a Department of Emergency Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-Gu, Seoul 110-744, Republic of Korea b Institute of Health Policy and Management, Medical Research Center, College of Medicine, Seoul National University, Seoul, Republic of Korea c Center for Education and Training of EMS and Rescue, Seoul Fire Academy, Seoul, Republic of Korea d Department of Preventive Medicine, Inha University College of Medicine, Republic of Korea e Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA, USA f Korea Centers for Disease Control and Prevention, Republic of Korea |
| Abstract: | Study objectivesWe sought to examine the association between area deprivation and outcomes of out-of-hospital cardiac arrest in Korea.MethodsData were obtained from the emergency medical service (EMS) system. A nationwide OHCA cohort database from January2006 to December 2007 was constructed via hospital chart review and ambulance run sheet data. We enrolled all EMS-assessed OHCA victims and excluded cases without available hospital outcome data or residential address. The Carstairs index was used to categorize districts according to level of deprivation into five quintiles, from (Q1, the least deprived) to (Q5, the most deprived). Main outcomes were survival to hospital discharge, survival to admission, and return of spontaneous circulation (ROSC).Results34,227 patients were included. Initial rhythm, witnessed status, attempted bystander cardiopulmonary resuscitation (CPR), CPR by EMS, CPR in the emergency department (ED), and elapsed time interval significantly varied according to area deprivation level (p < 0.001). OHCA outcomes were consistently worse in the most deprived areas. The adjusted OR (95% CI) for survival to hospital discharge was 0.58 (0.45-0.77) in the most deprived areas compared to the least deprived areas.ConclusionCommunity deprivation was strongly associated with survival among out-of-hospital cardiac arrest patients in Korea. |
| Keywords: | Cardiac arrest Socioeconomic status Outcomes Deprivation index |
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