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Rigshospitalet - en del af Københavns Universitetshospital
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Socioeconomic differences in coronary procedures and survival after out-of-hospital cardiac arrest: A nationwide Danish study

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  • Sidsel Møller
  • Mads Wissenberg
  • Kristian Kragholm
  • Fredrik Folke
  • Carolina Malta Hansen
  • Kristian B Ringgren
  • Julie Andersen
  • Carlo Barcella
  • Freddy Lippert
  • Lars Køber
  • Gunnar Gislason
  • Thomas Alexander Gerds
  • Christian Torp-Pedersen
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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.

OriginalsprogEngelsk
TidsskriftResuscitation
Vol/bind153
Sider (fra-til)10-19
Antal sider10
ISSN0300-9572
DOI
StatusUdgivet - 2020

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