Significant association between household income and risk for out-of-hospital cardiac arrest.
Raises the risk of cardiac arrest
Circulation: Cardiovascular Quality and Outcomes published the retrospective cohort study’s findings.
According to research by Benjamin P. van Nieuwenhuizen, PhD, of the department of public and occupational health at Amsterdam University Medical Center, and colleagues.
“We find a consistent, graded association between low household and personal income and higher risk of out-of-hospital cardiac arrest in women and men aged 25 years or older.
” When short follow-up times were taken into account, the graded association was still present. This offers stronger proof that having less money may make you more likely to experience an out-of-hospital cardiac arrest.
This suggests that low-income populations make a good target for resuscitation training initiatives and primary prevention plans that concentrate on out-of-hospital cardiac arrest.
Van Nieuwenhuizen and associates performed a retrospective study of more than 1.6 million adults living in the registry catchment area in a Dutch province using the Amsterdam Resuscitation Studies (ARREST) registry.
Using various demographic and income registries, 5,493 out-of-hospital cardiac arrest cases were linked in total.
Based on household income, participants were divided into quintiles: the first quintile contained the participants with the highest household income, while the fifth quintile contained the participants with the lowest household income.
The study’s participants had a median age of 48 for men and 49 for women. For women, the median age at the time of cardiac arrest outside of the hospital was 70, while for men it was 65.
The overall incidence of out-of-hospital cardiac arrest per 100,000 person-years over a mean follow-up of 2,395 days was 30.9 in women and 87.1 in men.
Researchers calculated that among participants in the second to lowest quintiles of household income, the HR for out-of-hospital cardiac arrest ranged from 0.95 (95% CI, 0.68-1.34) to 2.3 (95% CI, 1.74-3.05) in men and 1.24 (95% CI, 1.01-1.51) to 1.75 (95% CI, 1.46-2.1) in women.
According to the study, the HR for out-of-hospital cardiac arrest ranged from 0.95 (95% CI, 0.68-1.34) to 2.3 (95% CI, 1.74-3.05) for women and 1.28 (95% CI, 1.16-1.42) and 1.68 (95% CI, 1.48-1.89) for men when the lower four quintiles of personal income — rather than household — were compared with the highest quintile.
Additional analyses that excluded early follow-up times, people with comorbidities, had a smaller catchment area, and used a broader definition of sudden cardiac death also produced findings that were comparable to those of the primary analysis.
“While our hypothesis suggested that having low income might increase the risk of experiencing an out-of-hospital cardiac arrest, it’s also possible that the causal effect runs the other way, i.e., that having poor health might have an impact on income level.
“Job loss or a reduction in working hours and, consequently, income, may result from disability brought on by poor health,” the researchers wrote.
Additionally, reliable results in analyses that did not include people with comorbidities at baseline support social causation.