White Michelle J, Loccoh Emefah C, Goble Monica M, Yu Sunkyung, Odetola Folafoluwa O, Russell Mark W
1Division of Pediatric Cardiology,Department of Pediatrics and Communicable Diseases,University of Michigan Congenital Heart Center,C.S. Mott Children's Hospital,Ann Arbor,MichiganUSA.
2Division of Critical Care Medicine,Department of Pediatrics and Communicable Diseases,University of Michigan,C.S. Mott Children's Hospital,Ann Arbor,MichiganUSA.
Prehosp Disaster Med. 2017 Jun;32(3):269-272. doi: 10.1017/S1049023X17000048. Epub 2017 Feb 20.
Introduction Sudden cardiac death (SCD) is responsible for 5%-10% of all deaths among children 5-19 years-of-age. The incidence of SCD in youth in Michigan (USA) and nationwide is higher in racial/ethnic minorities and in certain geographic areas. School cardiac emergency response plans (CERPs) increase survival after cardiac arrest. However, school cardiac emergency preparedness remains variable. Studying population-level factors associated with school cardiac emergency preparedness and incidence of SCD in the young may improve understanding of disparities in the incidence of SCD. Hypothesis/Problem The objective of this pilot study was to determine the association of elements of high school cardiac emergency preparedness, including Automated External Defibrillator (AED) distribution and the presence of CERPs with county sociodemographic characteristics and county incidence of SCD in the young.
Surveys were sent to representatives from all public high schools in 30 randomly selected Michigan counties. Counties with greater than 50% response rate were included (n=19). Association of county-level sociodemographic characteristics with incidence of SCD in the young and existence of CERPs were evaluated using Spearman correlation coefficient.
Factors related to the presence of AEDs were similar across counties. Schools in counties of lower socioeconomic status (SES; lower-median income, lower per capita income, and higher population below poverty level) were less likely to have a CERP than those with higher SES (all P<.01). Lack of a CERP was associated with a higher incidence of SCD in youth (r=-0.71; P=.001). Overall incidence of SCD in youth was higher in lower SES counties (r=-0.62 in median income and r=0.51 in population below poverty level; both P<.05).
County SES is associated with the presence of CERPs in schools, suggesting a link between school cardiac emergency preparedness and county financial resources. Additionally, counties of lower SES demonstrated higher incidence of SCD in the young. Statewide and national studies are required to further explore the factors relating to geographic and socioeconomic differences in cardiac emergency preparedness and the incidence of SCD in the young. White MJ , Loccoh EC , Goble MM , Yu S , Odetola FO , Russell MW . High school cardiac emergency response plans and sudden cardiac death in the young. Prehosp Disaster Med. 2017;32(3):269-272.
引言 心源性猝死(SCD)占5至19岁儿童死亡总数的5% - 10%。在美国密歇根州及全国范围内,青年人心源性猝死的发生率在少数种族/族裔群体以及某些地理区域更高。学校心脏应急响应计划(CERP)可提高心脏骤停后的生存率。然而,学校心脏应急准备情况仍然参差不齐。研究与学校心脏应急准备以及青年人心源性猝死发生率相关的人群层面因素,可能有助于增进对心源性猝死发生率差异的理解。假设/问题 本试点研究的目的是确定高中心脏应急准备要素之间的关联,包括自动体外除颤器(AED)的配备情况以及CERP的存在情况与县社会人口学特征以及青年人心源性猝死发生率之间的关系。
向密歇根州随机选取的30个县的所有公立高中代表发放调查问卷。回复率超过50%的县被纳入研究(n = 19)。使用斯皮尔曼相关系数评估县级社会人口学特征与青年人心源性猝死发生率以及CERP存在情况之间的关联。
各县与AED配备相关的因素相似。社会经济地位(SES)较低的县(收入中位数较低、人均收入较低且贫困线以下人口比例较高)的学校比SES较高的县的学校更不太可能拥有CERP(所有P <.01)。缺乏CERP与青年人心源性猝死发生率较高相关(r = -0.71;P =.001)。SES较低的县青年人心源性猝死的总体发生率更高(收入中位数方面r = -0.62,贫困线以下人口方面r = 0.51;两者P <.05)。
县SES与学校CERP的存在情况相关,这表明学校心脏应急准备与县财政资源之间存在联系。此外,SES较低的县青年人心源性猝死发生率更高。需要开展全州范围和全国范围的研究,以进一步探索与心脏应急准备以及青年人心源性猝死发生率的地理和社会经济差异相关的因素。怀特MJ、洛科赫EC、戈布尔MM、于S、奥德托拉FO、拉塞尔MW。高中心脏应急响应计划与青年人心源性猝死。《院前灾难医学》。2017;32(3):269 - 272。