Socioeconomic status and incidence of cardiac arrest: a spatial approach to social and territorial disparities
Socioeconomic status and incidence of cardiac arrest: a spatial approach to social and territorial disparities
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DOI：
10.1097/mej.0000000000000534
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发表时间：
2019-06-01
影响因子：
4.4
通讯作者：
Hubert, Herve
中科院分区：
文献类型：
--
作者：
Castra, Laurent;Genin, Michael;Hubert, Herve
目的心脏骤停（CA）被认为是一个重大的公共卫生问题。很少有研究关注发病率的地理差异和社会经济特征。本研究的目的是确定高或低CA发病率的城市集群，并找到与之相关的社会经济因素。患者和方法从法国CA登记处提取来自巴黎三个县（代表123个市镇）的CA数据。每个城市的社会经济数据是从法国国家统计局收集的。我们采用统计学方法结合贝叶斯方法来研究CA的地理发病率变化，并通过扫描统计来确定城市CA的发病率集群。最后，我们从社会经济因素的角度比较了城市集群。结果123个市存在明显的地理差异：34个市发病率显著增高，37个市发病率显著降低。扫描统计发现7个显著的CA发病空间聚类，包括3个低发病聚类（相对危险度为0.23 ~ 0.54）和4个高发病聚类（相对危险度为1.43 ~ 2）。CA发病率高的城市群的特点是社会经济地位低于其他城市群（低和正常CA发病率集群）。分析显示，社会剥夺因素与高发病率之间存在统计学上的显著关系。结论CA发病率存在明显的地理差异，发病率过高与社会剥夺变量之间存在显著的统计学关系。版权所有2018威科集团有限公司版权所有。
Objective Cardiac arrest (CA) is considered a major public health issue. Few studies have focused on geographic variations in incidence and socioeconomic characteristics. The aim of this study is to identify clusters of municipalities with high or low CA incidence, and find socioeconomic factors associated with them.Patients and methods CA data from three Parisian counties, representing 123 municipalities, were extracted from the French CA registry. Socioeconomic data for each municipality were collected from the French national institute of statistics. We used a statistical approach combining Bayesian methods to study geographical CA incidence variations, and scan statistics, to identify CA incidence clusters of municipalities. Finally, we compared clusters of municipalities in terms of socioeconomic factors.Results Strong geographical variations were found among 123 municipalities: 34 presented a significantly increased risk of incidence and 37 presented a significantly low risk. Scan statistics identified seven significant spatial clusters of CA incidence, including three clusters with low incidence (the relative risk varied from 0.23 to 0.54) and four clusters with high incidence (the relative risk varied from 1.43 to 2). Clusters of municipalities with a high CA incidence are characterized by a lower socioeconomic status than the others (low and normal CA incidence clusters). Analysis showed a statistically significant relationship between social deprivation factors and high incidence.Conclusion This study shows strong geographical variations in CA incidence and a statistically significant relationship between over-incidence and social deprivation variables. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.