Association of Neighborhood Race and Income With Survival After Out-of-Hospital Cardiac Arrest
Association of Neighborhood Race and Income With Survival After Out-of-Hospital Cardiac Arrest
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DOI：
10.1161/jaha.119.014178
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发表时间：
2020-02-18
影响因子：
5.4
通讯作者：
Spertus, John A.
中科院分区：
文献类型：
--
作者：
Chan, Paul S.;McNally, Bryan;Spertus, John A.
背景：院外心脏骤停（OHCA）患者的生存可能受到发生心脏骤停的社区的影响。方法和结果在国家CARES（心脏骤停登记处以提高生存）登记处，我们从2013年至2017年确定了169 502例OHCA患者。根据人口普查区的数据，ohca被分类为主要发生在白人（白人占80%），黑人占多数（黑人占50%），或综合社区（两者都不是）和低收入社区（家庭中位数为80,000美元）。采用层次逻辑回归，评估社区种族和收入对总生存率的影响。总体而言，在以白人为主、黑人为主和融合社区中，有37.5%、16.6%和45.9%的人患有OHCA；在低收入、中等收入和高收入社区中，分别有30.1%、53.4%和16.5%的人患有OHCA。与主要发生在白人社区的ohca相比，主要发生在黑人社区的可能性低12%(6.9%对10.6%；调整后优势比0.88;95% CI 0.82-0.95； P
Background For individuals with an out-of-hospital cardiac arrest (OHCA), survival may be influenced by the neighborhood in which the arrest occurs.Methods and Results Within the national CARES (Cardiac Arrest Registry to Enhance Survival) registry, we identified 169 502 patients with OHCA from 2013 to 2017. On the basis of census tract data, OHCAs were categorized as occurring in predominantly white (>80% white), majority black (>50% black), or integrated (neither of these 2) neighborhoods and in low-income (median household $80 000) neighborhoods. With hierarchical logistic regression, the association of neighborhood race and income on overall survival was assessed. Overall, 37.5%, 16.6%, and 45.9% of people had an OHCA in predominantly white, majority black, and integrated neighborhoods, and 30.1%, 53.4%, and 16.5% in low-, middle-, and high-income neighborhoods, respectively. Compared with OHCAs occurring in predominantly white neighborhoods, those in majority black neighborhoods were 12% less likely (6.9% versus 10.6%; adjusted odds ratio 0.88; 95% CI 0.82-0.95; P