• Resuscitation · Nov 2020

    Income is associated with the probability to receive early coronary angiography after out-of-hospital cardiac arrest.

    • Rickard Lagedal, Martin Jonsson, Ludvig Elfwén, David Smekal, Per Nordberg, Stefan James, and Sten Rubertsson.
    • Department of Surgical Sciences/Anesthesiology and Intensive Care Medicine, Uppsala University, Sweden.
    • Resuscitation. 2020 Nov 1; 156: 35-41.

    IntroductionLow socioeconomic status has been associated with worse outcome after cardiac arrest. This study aims to investigate if patients´ income influences the probability to receive early coronary angiography in out-of-hospital cardiac arrest (OHCA) patients.MethodsIn this nationwide retrospective observational study, 3906 OHCA patients admitted alive and registered in the Swedish Registry for Cardiopulmonary Resuscitation were included. Individual data on income and educational level, prehospital parameters, coronary angiography results and comorbidity were linked from SWEDEHEART and other national registers.ResultsPatients were divided into quarters depending on their income level. In the unadjusted model there was a strong correlation between income level and rate of early coronary angiography where 35.5% of patients in the highest income quarters received early angiography compared to 15.4% in the lowest income quarters. When adjusting for educational level, sex, age, comorbidity and hospital type, there were still higher chance of receiving early coronary angiography with increasing income, OR 1.31 (CI 1.01-1.68) and 1.67 (CI 1.29-2.16) for the two highest income quarters respectively compared to the lowest income quarter. When adding potential mediators to the model (first recorded ECG rhythm by the EMS, location, response time, bystander cardiopulmonary resuscitation and if the arrest was witnessed) no difference in early angiography related to income level where found. The main mediator was first recorded ECG rhythm.ConclusionIncome level is associated with the probability to undergo early coronary angiography in OHCA patients. This association seems to be mediated by the initial ECG rhythm.Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.

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