Association Between Income and Risk of Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Study.

IF 6.9 2区医学

Circulation. Cardiovascular Quality and Outcomes Pub Date : 2023-02-01 DOI:10.1161/CIRCOUTCOMES.122.009080

Benjamin P van Nieuwenhuizen, Hanno L Tan, Marieke T Blom, Anton E Kunst, Irene G M van Valkengoed

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引用次数: 1

Abstract

Background: Previous studies have observed a higher out-of-hospital cardiac arrest (OHCA) risk among lower socioeconomic groups. However, due to the cross-sectional and ecological designs used in these studies, the magnitude of these inequalities is uncertain. This study is the first to assess the individual-level association between income and OHCA using a large-scale longitudinal study.

Methods: This retrospective cohort study followed 1 688 285 adults aged 25 and above, living in the catchment area of an OHCA registry in a Dutch province. OHCA cases (n=5493) were linked to demographic and income registries. Cox proportional hazard models were conducted to determine hazard ratios of OHCA for household and personal income quintiles, stratified by sex and age.

Results: The total incidence of OHCA per 100 000 person years was 30.9 in women and 87.1 in men. A higher OHCA risk was observed with lower household and personal income. Compared with the highest household income quintile, the adjusted hazard ratios from the second highest to the lowest household income quintiles ranged from 1.24 (CI=1.01-1.51) to 1.75 (CI=1.46-2.10) in women and from 0.95 (CI=0.68-1.34) to 2.30 (CI=1.74-3.05) in men. For personal income, this ranged from 0.95 (CI=0.68-1.34) to 2.30 (CI=1.74-3.05) in women and between 1.28 (CI=1.16-1.42) and 1.68 (CI=1.48-1.89) in men. Comparable household and personal income gradients were found across age groups except in the highest (>84 years) age group. For example, household income in women aged 65 to 74 ranged from 1.25 (CI=1.02-1.52) to 1.65 (CI=1.36-2.00). Sensitivity analyses assessing the prevalence of comorbidities at baseline and different lengths of follow-up yielded similar estimates.

Conclusions: This study provides new evidence for a substantial increase in OHCA risk with lower income in different age and sex groups. Low-income groups are likely to be a suitable target for intervention strategies to reduce OHCA risk.

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收入与院外心脏骤停风险之间的关系:一项回顾性队列研究

背景:以前的研究已经观察到低社会经济群体的院外心脏骤停(OHCA)风险较高。然而，由于这些研究中使用的横截面和生态设计，这些不平等的程度是不确定的。本研究首次使用大规模的纵向研究来评估收入与职业健康风险之间的个人水平关联。方法:本回顾性队列研究随访了1688285名年龄在25岁及以上的成年人，他们居住在荷兰某省OHCA登记处的集水区。OHCA病例(n=5493)与人口和收入登记相关联。采用Cox比例风险模型确定按性别和年龄分层的家庭和个人收入五分位数的OHCA风险比。结果:OHCA的总发病率为每10万人年女性30.9例，男性87.1例。家庭和个人收入越低，OHCA风险越高。与最高家庭收入五分位数相比，第二高至最低家庭收入五分位数的调整风险比在女性中为1.24 (CI=1.01-1.51)至1.75 (CI=1.46-2.10)，在男性中为0.95 (CI=0.68-1.34)至2.30 (CI=1.74-3.05)。对于个人收入，女性的这一区间为0.95 (CI=0.68-1.34)至2.30 (CI=1.74-3.05)，男性为1.28 (CI=1.16-1.42)至1.68 (CI=1.48-1.89)。除了最高(>84岁)年龄组外，各年龄组的家庭和个人收入梯度都具有可比性。例如，65至74岁妇女的家庭收入从1.25 (CI=1.02-1.52)到1.65 (CI=1.36-2.00)不等。在基线和不同随访时间评估合并症患病率的敏感性分析得出了相似的估计。结论:本研究为不同年龄和性别群体中低收入人群的OHCA风险显著增加提供了新的证据。低收入群体可能是降低职业健康风险的干预策略的合适目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Circulation. Cardiovascular Quality and Outcomes Medicine-Cardiology and Cardiovascular Medicine

CiteScore

9.80

自引率

2.90%

发文量

357

期刊介绍： Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal, publishes articles related to improving cardiovascular health and health care. Content includes original research, reviews, and case studies relevant to clinical decision-making and healthcare policy. The online-only journal is dedicated to furthering the mission of promoting safe, effective, efficient, equitable, timely, and patient-centered care. Through its articles and contributions, the journal equips you with the knowledge you need to improve clinical care and population health, and allows you to engage in scholarly activities of consequence to the health of the public. Circulation: Cardiovascular Quality and Outcomes considers the following types of articles: Original Research Articles, Data Reports, Methods Papers, Cardiovascular Perspectives, Care Innovations, Novel Statistical Methods, Policy Briefs, Data Visualizations, and Caregiver or Patient Viewpoints.