Center for Resusctitation Science, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
J Epidemiol Community Health. 2020 Sep;74(9):726-731. doi: 10.1136/jech-2019-213296. Epub 2020 May 8.
The association between socioeconomic status (SES) and incidence of out-of-hospital cardiac arrest (OHCA) is not fully understood. The aim of this study was to see if area-level socioeconomic differences, measured in terms of area-level income and education, are associated with the incidence of OHCA, and if this relationship is dependent on age.
We included OHCAs that occurred in Stockholm County between the 1st of January 2006 and the 31st of December 2017, the victims being confirmed residents (n=10 574). We linked the home address to a matching neighbourhood (base unit) via available socioeconomic and demographic information. Socioeconomic variables and incidence rates were assessed by using cross-sectional values at the end of each year. We used zero-inflated negative binomial regression to calculate incidence rate ratios (IRRs).
Among 1349 areas with complete SES information, 10 503 OHCAs occurred between 2006 and 2017. The IRR in the highest versus the lowest SES area was 0.61 (0.50-0.75) among persons in the 0-44 age group. Among patients in the 45-64 age group, the corresponding IRR was 0.55 (0.47-0.65). The highest SES areas versus the lowest showed an IRR of 0.59 (0.50-0.70) in the 65-74 age group. In the two highest age groups, no significant association was seen (75-84 age group: 0.93 (0.80-1.08); 85+ age group: 1.05 (0.84-1.23)). Similar crude patterns were seen among both men and women.
Areas characterised by high SES showed a significantly lower incidence of OHCA. This relationship was seen up to the age of 75, after which the relationship disappeared, suggesting a levelling effect.
社会经济地位（SES）与院外心脏骤停（OHCA）发生率之间的关系尚不完全清楚。本研究的目的是观察以区域收入和教育水平衡量的区域社会经济差异是否与 OHCA 的发生率相关，以及这种关系是否取决于年龄。
我们纳入了 2006 年 1 月 1 日至 2017 年 12 月 31 日期间发生在斯德哥尔摩县的 OHCA，受害者被确认为常住居民（n=10574）。我们通过可用的社会经济和人口统计信息将家庭住址与匹配的社区（基本单位）相关联。使用每年年底的横截面值评估社会经济变量和发病率。我们使用零膨胀负二项回归计算发病率比（IRR）。
在具有完整 SES 信息的 1349 个区域中，2006 年至 2017 年期间发生了 10503 例 OHCA。0-44 岁年龄组中，最高 SES 区与最低 SES 区的 IRR 为 0.61（0.50-0.75）。45-64 岁患者的相应 IRR 为 0.55（0.47-0.65）。65-74 岁年龄组中，最高 SES 区与最低 SES 区的 IRR 为 0.59（0.50-0.70）。在两个最高年龄组中，未见明显相关性（75-84 岁年龄组：0.93（0.80-1.08）；85+岁年龄组：1.05（0.84-1.23））。男性和女性均表现出类似的粗模式。
SES 较高的区域 OHCA 发生率明显较低。这种关系在 75 岁之前存在，之后这种关系消失，表明存在平衡效应。
