Gonuguntla Karthik, Chobufo Muchi Ditah, Shaik Ayesha, Patel Neel, Penmetsa Mouna, Sattar Yasar, Thyagaturu Harshith, Chan Paul S, Balla Sudarshan
Division of Cardiology, West Virginia University Heart & Vascular Institute, Morgantown, WV, USA.
Department of Cardiology, Hartford Hospital, Hartford, CT, USA.
medRxiv. 2023 Aug 4:2023.08.02.23293573. doi: 10.1101/2023.08.02.23293573.
Cardiac arrest is one of the leading causes of morbidity and mortality, with an estimated 340,000 out-of-hospital and 292,000 in-hospital cardiac arrest events per year in the U.S. Survival rates are lower in certain racial and socioeconomic groups.
To examine the impact of social determinants on cardiac arrest mortality among adults stratified by age, race, and sex in the U.S.
A county-level cross-sectional longitudinal study using death data between 2016 and 2020 from the Centers for Disease Control and Prevention's (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) database.
Using the multiple causes of death dataset from the CDC's WONDER database, cardiac arrests were identified using the International Classification of Diseases (ICD), tenth revision, clinical modification codes.
Individuals aged 15 years or more whose death was attributed to cardiac arrest.
Social vulnerability index (SVI), reported by the CDC, is a composite measure that includes socioeconomic vulnerability, household composition, disability, minority status and language, and housing and transportation domains.
Cardiac arrest mortality per 100,000 adults.
Overall age-adjusted cardiac arrest mortality (AAMR) during the study period was 95.6 per 100,000 persons. The AAMR was higher for men as compared with women (119.6 vs. 89.9 per 100,000) and for Black, as compared with White, adults (150.4 vs. 92.3 per 100,000). The AAMR increased from 64.8 per 100,000 persons in counties in Quintile 1 (Q1) of SVI to 141 per 100,000 persons in Quintile 5, with an average increase of 13% (95% CI: 9.8-16.9) in AAMR per quintile increase.
Mortality from cardiac arrest varies widely, with a more than 2-fold difference between the counties with the highest and lowest social vulnerability, highlighting the differential burden of cardiac arrest deaths throughout the U.S. based on social determinants of health.
心脏骤停是发病和死亡的主要原因之一，在美国，估计每年有34万例院外心脏骤停事件和29.2万例院内心脏骤停事件。某些种族和社会经济群体的生存率较低。
研究社会决定因素对美国按年龄、种族和性别分层的成年人心脏骤停死亡率的影响。
一项县级横断面纵向研究，使用了疾病控制与预防中心（CDC）的广泛在线流行病学研究数据（WONDER）数据库中2016年至2020年的死亡数据。
使用CDC的WONDER数据库中的多种死因数据集，通过国际疾病分类（ICD）第十次修订版临床修正代码识别心脏骤停。
死亡归因于心脏骤停的15岁及以上个体。
由CDC报告的社会脆弱性指数（SVI）是一种综合指标，包括社会经济脆弱性、家庭构成、残疾、少数族裔身份和语言以及住房和交通领域。
每10万成年人的心脏骤停死亡率。
研究期间总体年龄调整后的心脏骤停死亡率（AAMR）为每10万人95.6例。男性的AAMR高于女性（每10万人分别为119.6例和89.9例），黑人成年人的AAMR高于白人成年人（每10万人分别为150.4例和92.3例）。AAMR从SVI五分位数第1组（Q1）县的每10万人64.8例增加到五分位数第5组的每10万人141例，每增加一个五分位数，AAMR平均增加13%（95%CI：9.8 - 16.9）。
心脏骤停死亡率差异很大，社会脆弱性最高和最低的县之间相差两倍多，突出了基于健康社会决定因素的美国各地心脏骤停死亡的差异负担。
