Sidsel Møller1, Mads Wissenberg2, Kristian Kragholm3, Fredrik Folke2, Carolina Malta Hansen2, Kristian B Ringgren3, Julie Andersen4, Carlo Barcella5, Freddy Lippert6, Lars Køber7, Gunnar Gislason8, Thomas Alexander Gerds9, Christian Torp-Pedersen10. 1. Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. Electronic address: sidsel.gamborg.moeller@regionh.dk. 2. Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; Copenhagen Emergency Medical Services, University of Copenhagen, Denmark. 3. Department of Cardiology, North Denmark Regional Hospital & Aalborg University Hospital, Denmark. 4. Danish Heart Foundation, Department of Research, Copenhagen, Denmark. 5. Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. 6. Copenhagen Emergency Medical Services, University of Copenhagen, Denmark. 7. The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 8. Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; Danish Heart Foundation, Department of Research, Copenhagen, Denmark; The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. 9. Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. 10. Department of Cardiology, North Denmark Regional Hospital & Aalborg University Hospital, Denmark; Department of Cardiology, North Zealand Hospital, The Capital Region of Denmark, Denmark.
Abstract
AIM: It remains unclear whether socioeconomic differences exist in post-resuscitation care in out-of-hospital cardiac arrests (OHCA). We aimed to examine socioeconomic differences in coronary procedures and survival after OHCA. METHODS: OHCA patients ≥30 years of cardiac cause with a hospital admission from the Danish Cardiac Arrest Registry, 2001-2014, were divided according to quartiles of household income (lowest, low, high, highest). Associations of income, coronary procedures and 30-day survival were examined by age-standardized incidence rates and incidence rate ratios (IRR), and by logistic regression. RESULTS: A total of 6105 patients were included. Higher-income patients were younger, males and had less comorbidity-burden. Higher-income patients had higher incidence rates for coronary angiographies both day 0-1 and day 2-7 after OHCA (day 0-1: highest: IRR 1.79, 95%CI 1.46-2.21; high: IRR 1.28, 95%CI 1.10-1.51; low: IRR 1.05, 95%CI 0.90-1.23), compared to lowest. Fifty-four percentage of the patients undergoing a coronary angiography received percutaneous-coronary-intervention or coronary-artery-bypass-grafting with no difference among three of the four groups, but lower IRR in low-income patients (IRR 0.74, 95%CI 0.61-0.89) compared to lowest. Higher-income patients had also higher odds for 30-day survival compared to lowest, both in patients with (highest: OR 1.61, 95%CI 1.12-2.32; high: OR 1.13, 95%CI 0.80-1.60; low: OR 1.14, 95%CI 0.81-1.61) and without (highest: OR 2.54, 95%CI 1.83-3.53; high: OR 1.41, 95%CI 1.06-1.87; low: OR 1.12, 95%CI 0.86-1.47) coronary angiography day 0-1. CONCLUSION: Higher-income patients were found associated with more performed coronary angiographies after OHCA, and higher odds for 30-day survival.
AIM: It remains unclear whether socioeconomic differences exist in post-resuscitation care in out-of-hospital cardiac arrests (OHCA). We aimed to examine socioeconomic differences in coronary procedures and survival after OHCA. METHODS: OHCA patients ≥30 years of cardiac cause with a hospital admission from the Danish Cardiac Arrest Registry, 2001-2014, were divided according to quartiles of household income (lowest, low, high, highest). Associations of income, coronary procedures and 30-day survival were examined by age-standardized incidence rates and incidence rate ratios (IRR), and by logistic regression. RESULTS: A total of 6105 patients were included. Higher-income patients were younger, males and had less comorbidity-burden. Higher-income patients had higher incidence rates for coronary angiographies both day 0-1 and day 2-7 after OHCA (day 0-1: highest: IRR 1.79, 95%CI 1.46-2.21; high: IRR 1.28, 95%CI 1.10-1.51; low: IRR 1.05, 95%CI 0.90-1.23), compared to lowest. Fifty-four percentage of the patients undergoing a coronary angiography received percutaneous-coronary-intervention or coronary-artery-bypass-grafting with no difference among three of the four groups, but lower IRR in low-income patients (IRR 0.74, 95%CI 0.61-0.89) compared to lowest. Higher-income patients had also higher odds for 30-day survival compared to lowest, both in patients with (highest: OR 1.61, 95%CI 1.12-2.32; high: OR 1.13, 95%CI 0.80-1.60; low: OR 1.14, 95%CI 0.81-1.61) and without (highest: OR 2.54, 95%CI 1.83-3.53; high: OR 1.41, 95%CI 1.06-1.87; low: OR 1.12, 95%CI 0.86-1.47) coronary angiography day 0-1. CONCLUSION: Higher-income patients were found associated with more performed coronary angiographies after OHCA, and higher odds for 30-day survival.
Authors: Martin Jonsson; Juho Härkönen; Petter Ljungman; Per Nordberg; Mattias Ringh; Geir Hirlekar; Araz Rawshani; Johan Herlitz; Rickard Ljung; Jacob Hollenberg Journal: Circulation Date: 2021-11-12 Impact factor: 29.690