Incidence of sudden cardiac arrest is higher in areas of low socioeconomic status: A prospective two year study in a large United States community
Incidence of sudden cardiac arrest is higher in areas of low socioeconomic status: A prospective two year study in a large United States community
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DOI：
10.1016/j.resuscitation.2005.11.018
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发表时间：
2006-08-01
期刊：
影响因子：
6.5
通讯作者：
Chugh, Sumeet S.
中科院分区：
文献类型：
--
作者：
Reinier, Kyndaron;Stecker, Eric C.;Chugh, Sumeet S.
背景：社会经济地位对社区心脏骤停发生的潜在影响是可能的，但尚未得到充分的评估。方法：对俄勒冈州Multnomah县（2002年2月- 2004年1月）人口660,486例心脏骤停病例进行前瞻性调查，并根据居住地址和发生心脏骤停的具体地理位置按人口普查区进行分类。每个人口普查区被分配到收入中位数、贫困水平、房屋价值中位数和教育程度的四分位数。结果：714例（年发病率54 / 10万）中，697例（98%）的居住地址与县人口普查区匹配。对于每个社会经济地位的测量，最低社会经济地位人口普查区的心脏骤停发生率比最高社会经济地位人口普查区高30-80%。在人口普查区中，与房屋中位数最高的四分位数相比，最低四分位数的年发病率为60.5比35.1 / 100,000 （RR 1.7, 95% Cl 1.4-2.2）。对于年龄< 65岁的人群，这一梯度被显著夸大（34.5比15.1 / 100000,RR 2.3, 95% Cl 1.6-3.3）。基于地理位置的心脏骤停也有相同的趋势，60%的病例和66%的年龄< 65岁的病例发生在社会经济地位最低的两个四分位数。结论：低社区社会经济地位与心脏骤停发生率显著升高相关，这与居住地址和心脏骤停发生地点有关。为了有效部署以社区为基础的预防策略，如自动体外除颤器，社区的社会经济地位可能是一个重要的考虑因素。(c) 2006年由爱思唯尔爱尔兰有限公司出版
Background: A potential effect of socioeconomic status on occurrence of sudden cardiac arrest in the community is likely, but has not been evaluated fully.Methods: All cases of sudden cardiac arrest in Multnomah County Oregon (population 660,486; February 2002-January 2004) were identified prospectively and categorized by census tract based on the address of residence and specific geographic location of occurrence of cardiac arrest. Each census tract was assigned to quartiles of median income, poverty level, median home value, and educational attainment.Results: Of 714 cases (annual incidence 54 per 100,000), 697 (98%) had residential addresses that matched a county census tract successfully. For each socioeconomic status measure, the incidence of cardiac arrest was 30-80% higher in the lowest compared to the highest socioeconomic status census tracts. Annual incidence in census tracts in the lowest compared to the highest quartiles of median home value was 60.5 versus 35.1 per 100,000 (RR 1.7, 95% Cl 1.4-2.2). This gradient was exaggerated significantly for age < 65 years (34.5 versus 15.1 per 100,000, RR 2.3, 95% Cl 1.6-3.3). Identical trends were observed for sudden cardiac arrest based on location, with 60% of all cases and 66% of cases age < 65 years occurring in the two quartiles with lowest socioeconomic status.Conclusions: Low neighborhood socioeconomic status was associated with a significantly higher incidence of sudden cardiac arrest based on address of residence as well as location of cardiac arrest. For effective deployment of strategies for community-based prevention such as the automated external defibrillator, neighborhood socioeconomic status is likely to be an important consideration. (c) 2006 Published by Elsevier Ireland Ltd.