Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
School of Interdisciplinary Science, Faculty of Science, McMaster University, Hamilton, ON, Canada.
Resuscitation. 2023 Nov;192:109931. doi: 10.1016/j.resuscitation.2023.109931. Epub 2023 Aug 9.
Paediatric out-of-hospital cardiac arrest (POHCA) is associated with poor survival and severe neurological sequelae. We conducted a systematic review on the impact of sociodemographic factors across different stages of POHCA.
We searched MEDLINE, EMBASE, and Web of Science from database inception to October 2022. We included studies examining the association between sociodemographic factors (i.e., race, ethnicity, migrant status and socioeconomic status [SES]) and POHCA risk, bystander cardiopulmonary resuscitation (CPR) provision, bystander automated external defibrillator (AED) application, survival (at or 30-days post-discharge), and neurological outcome. We synthesized the data qualitatively.
We screened 11,097 citations and included 18 articles (arising from 15 studies). There were 4 articles reporting on POHCA risk, 5 on bystander CPR provision, 3 on bystander AED application, 13 on survival, and 6 on neurological outcome. In all studies on POHCA risk, significant differences were found across racial groups, with minority populations being disproportionately impacted. There were no articles reporting on the association between SES and POHCA risk. Bystander CPR provision was consistently associated with race and ethnicity, with disparities impacting Black and Hispanic children. The association between bystander CPR provision and SES was variable. There was little evidence of socioeconomic or racial disparities in studies on bystander AED application, survival, and neurological outcome, particularly across adjusted analyses.
Race and ethnicity are likely associated with POHCA risk and bystander CPR provision. These findings highlight the importance of prioritizing at-risk groups in POHCA prevention and intervention efforts. Further research is needed to understand underlying mechanisms.
儿科院外心脏骤停（POHCA）与存活率低和严重的神经后遗症有关。我们对 POHCA 不同阶段的社会人口因素的影响进行了系统评价。
我们从数据库建立开始到 2022 年 10 月在 MEDLINE、EMBASE 和 Web of Science 上进行了搜索。我们纳入了研究社会人口因素（即种族、族裔、移民身份和社会经济地位[SES]）与 POHCA 风险、旁观者心肺复苏（CPR）提供、旁观者自动体外除颤器（AED）应用、生存（出院时或 30 天后）和神经结局之间关联的研究。我们对数据进行了定性综合。
我们筛选了 11097 条引文，纳入了 18 篇文章（来自 15 项研究）。其中 4 篇文章报告了 POHCA 风险，5 篇报告了旁观者 CPR 提供，3 篇报告了旁观者 AED 应用，13 篇报告了生存，6 篇报告了神经结局。在所有关于 POHCA 风险的研究中，不同种族群体之间存在显著差异，少数群体受到不成比例的影响。没有文章报告 SES 与 POHCA 风险之间的关联。旁观者 CPR 提供一直与种族和族裔有关，黑人和西班牙裔儿童存在差异。旁观者 CPR 提供与 SES 的关联是可变的。在旁观者 AED 应用、生存和神经结局的研究中，很少有社会经济或种族差异的证据，特别是在调整分析中。
种族和族裔可能与 POHCA 风险和旁观者 CPR 提供有关。这些发现强调了在 POHCA 预防和干预工作中优先考虑高危人群的重要性。需要进一步研究以了解潜在机制。
