Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry Western University London Ontario Canada.
ICES Western London Ontario Canada.
J Am Heart Assoc. 2024 Jan 2;13(1):e032718. doi: 10.1161/JAHA.123.032718. Epub 2024 Jan 3.
Pediatric out-of-hospital cardiac arrest (POHCA) is associated with significant mortality and poor neurological outcomes. We aimed to describe the association between sociodemographic factors and POHCA risk in Ontario, Canada.
We conducted a province-wide case-control study at ICES, where patient records are linked across administrative databases. The case group included children (aged 1 day to 17 years) who experienced an out-of-hospital cardiac arrest between 2004 and 2020. Controls were matched up to 1:4 on age, sex, index date, and key comorbidities. We used conditional logistic regression to measure the association between sociodemographic indicators and POHCA risk. The case and control groups included 1826 and 7254 children, respectively. Children living in areas with the highest levels of material deprivation (adjusted odds ratio [aOR], 2.35 [95% CI, 1.94-2.85]) and dependency (aOR, 1.22 [95% CI, 1.01-1.48]) had a higher odds of POHCA, relative to children living in regions with the lowest levels of material deprivation and dependency, respectively. Children living in neighborhoods with the lowest levels of ethnic diversity had a higher odds of POHCA (aOR, 1.62 [95% CI, 1.30-2.01]), relative to children living in neighborhoods with the highest levels of ethnic diversity. The odds of POHCA were lower in immigrants (aOR, 0.67 [95% CI, 0.47-0.95]), relative to the general population. Northern urban residence was associated with a higher odds of POHCA (aOR, 1.45 [95% CI, 1.13-1.87]), relative to southern urban residence.
Children living in neighborhoods with high levels of marginalization may have an elevated risk of experiencing POHCA. These findings highlight the importance of addressing disparities through targeted prevention and intervention efforts.
儿科院外心脏骤停（POHCA）与较高的死亡率和较差的神经学预后相关。我们旨在描述加拿大安大略省社会人口因素与 POHCA 风险之间的关系。
我们在 ICES 进行了一项全省范围的病例对照研究，在该研究中，患者记录在行政数据库之间进行了链接。病例组包括 2004 年至 2020 年间经历院外心脏骤停的 1 天至 17 岁的儿童。对照组按照年龄、性别、索引日期和主要合并症进行 1:4 匹配。我们使用条件逻辑回归来衡量社会人口学指标与 POHCA 风险之间的关系。病例组和对照组分别包括 1826 名和 7254 名儿童。与生活在物质匮乏程度最低的地区的儿童相比（调整后的优势比[aOR]，2.35 [95%CI，1.94-2.85]）和依赖程度（aOR，1.22 [95%CI，1.01-1.48]），生活在物质匮乏和依赖程度最高的地区的儿童 POHCA 的可能性更高。与生活在种族多样性最高的社区的儿童相比，生活在种族多样性最低的社区的儿童 POHCA 的可能性更高（aOR，1.62 [95%CI，1.30-2.01]）。与一般人群相比，移民的 POHCA 可能性较低（aOR，0.67 [95%CI，0.47-0.95]）。与南部城市居住相比，北部城市居住与 POHCA 发生的可能性较高相关（aOR，1.45 [95%CI，1.13-1.87]）。
生活在边缘化程度较高的社区的儿童可能面临更高的 POHCA 风险。这些发现强调了通过有针对性的预防和干预措施来解决差异的重要性。
