Hallstrom A, Boutin P, Cobb L, Johnson E
Department of Biostatistics, University of Washington, Seattle.
Am J Public Health. 1993 Feb;83(2):245-8. doi: 10.2105/ajph.83.2.245.
The association between socioeconomic status and cardiac arrest is less well known than some other associations with cardiac arrest. We used property tax assessments as a measure of socioeconomic status in a study of victims of out-of-hospital cardiac arrest found in ventricular fibrillation.
We studied patients attended by the Seattle Fire Department's emergency medical services system between May 1986 and August 1988. During the period studied, 356 episodes met the study criteria; 114 (32%) of these patients survived without major neurologic deficit. Residential property tax assessments were available for 253 of the patients.
After adjustments were made for age, witnessed collapse, bystander-initiated cardiopulmonary resuscitation, time from call to paramedic arrival, activity, location of collapse, and chronic morbidity, an association of survival with greater assessed value per living unit was observed. An increase of $50,000 in value per unit was associated with a 1.6-fold increase in survival rate.
Not only are persons in the lower socioeconomic strata at greater risk for cardiac mortality, but they are also less likely to survive an episode of out-of-hospital cardiac arrest.
社会经济地位与心脏骤停之间的关联,相较于其他一些与心脏骤停的关联,尚不为人熟知。在一项针对院外心脏骤停且为心室颤动患者的研究中,我们采用财产税评估作为社会经济地位的衡量指标。
我们研究了1986年5月至1988年8月期间由西雅图消防部门紧急医疗服务系统接诊的患者。在研究期间,356例发作符合研究标准;其中114例(32%)患者存活且无严重神经功能缺损。253例患者有住宅财产税评估数据。
在对年龄、目睹的心脏骤停、旁观者实施的心肺复苏、从呼叫到护理人员到达的时间、活动情况、心脏骤停地点以及慢性疾病进行调整后,观察到存活与每个居住单元评估价值更高之间存在关联。每单元价值增加5万美元,存活率增加1.6倍。
社会经济地位较低的人群不仅心脏死亡风险更高,而且院外心脏骤停发作后存活的可能性也更小。