Division of Cardiology West Virginia University Heart and Vascular Institute Morgantown WV.
Department of Cardiology Hartford Hospital Hartford CT.
J Am Heart Assoc. 2024 May 7;13(9):e033411. doi: 10.1161/JAHA.123.033411. Epub 2024 Apr 30.
Cardiac arrest is 1 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 United States. Survival rates are lower in certain racial and socioeconomic groups.
We performed a county-level cross-sectional longitudinal study using the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research multiple causes of death data set between 2016 and 2020 among individuals of all ages whose death was attributed to cardiac arrest. The Social Vulnerability Index is a composite measure that includes socioeconomic vulnerability, household composition, disability, individuals from racial and ethnic minority groups status and language, and housing and transportation domains. We examined the impact of social determinants on cardiac arrest mortality stratified by age, race, ethnicity, and sex in the United States. All age-adjusted mortality rate (cardiac arrest AAMRs) are reported as per 100 000. Overall cardiac arrest AAMR during the study period was 95.6. The cardiac arrest AAMR was higher for men compared with women (119.6 versus 89.9) and for the Black population compared with the White population (150.4 versus 92.3). The cardiac arrest AAMR increased from 64.8 in counties in quintile 1 of Social Vulnerability Index to 141 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 >2-fold difference between the counties with the highest and lowest social vulnerability, highlighting the differential burden of cardiac arrest deaths throughout the United States based on social determinants of health.
在美国，心脏骤停是发病率和死亡率的主要原因之一，每年估计有 34 万例院外和 29.2 万例院内心脏骤停事件。某些种族和社会经济群体的存活率较低。
我们使用疾病控制和预防中心的广范围在线流行病学研究多死因数据集，在 2016 年至 2020 年期间，对所有年龄段的个体进行了县级横断面纵向研究，这些个体的死亡归因于心脏骤停。社会脆弱性指数是一个综合指标，包括社会经济脆弱性、家庭构成、残疾、少数族裔和族裔地位和语言以及住房和交通领域。我们研究了社会决定因素对美国按年龄、种族、族裔和性别分层的心脏骤停死亡率的影响。所有年龄调整死亡率（心脏骤停 AAMR）均按每 10 万人报告。研究期间的总体心脏骤停 AAMR 为 95.6。与女性（119.6 比 89.9）和黑人（150.4 比 92.3）相比，男性的心脏骤停 AAMR 更高。心脏骤停 AAMR 从社会脆弱性指数五分位数 1 的 64.8 增加到五分位数 5 的 141，每五分位数增加 AAMR 平均增加 13%（95%CI，9.8%-16.9%）。
心脏骤停的死亡率差异很大，社会脆弱性最高和最低的县之间相差 2 倍以上，这突显了美国各地基于健康的社会决定因素的心脏骤停死亡的差异负担。
