Socioeconomic status and in-hospital cardiac arrest: A systematic review

Nikola Stankovic; Maria Høybye; Peter Carøe Lind; Mathias Holmberg; Lars W Andersen

doi:10.1016/j.resplu.2020.100016

Socioeconomic status and in-hospital cardiac arrest: A systematic review

Resusc Plus. 2020 Jul 9:3:100016. doi: 10.1016/j.resplu.2020.100016. eCollection 2020 Sep.

Authors

Nikola Stankovic¹, Maria Høybye¹, Peter Carøe Lind², Mathias Holmberg¹, Lars W Andersen^{1

2

3}

Affiliations

¹ Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Palle Juul Jensens Boulevard 99, Aarhus N, 8200, Denmark.
² Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
³ Prehospital Emergency Medical Services, Central Denmark Region, Olof Palmes Allé 34, Aarhus N, 8200, Denmark.

Abstract

Aim: To perform a review of the literature on the association between socioeconomic status and risk of and outcomes after in-hospital cardiac arrest.

Data sources: PubMed and Embase were searched on January 24, 2020 for studies evaluating the association between socioeconomic status and risk of and/or outcomes after in-hospital cardiac arrest. Two reviewers independently screened the titles/abstracts and selected full texts for relevance. Data were extracted from included studies. Risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool.

Results: The literature search yielded 4960 unique records. We included nine studies evaluating the association between socioeconomic status and risk of and/or outcomes after in-hospital cardiac arrest. All studies were observational cohort studies, of which seven were from the USA. Seven studies were in an adult population, while two studies were in a pediatric population. Results were overall inconsistent although some studies found a higher in-hospital cardiac arrest incidence in patients from low-income communities. There was no clear association between other socioeconomic factors (i.e. education, occupation, marital status, and insurance) and risk of or outcomes after in-hospital cardiac arrest. Due to the scarcity and heterogeneity of available studies, meta-analyses were not performed.

Conclusion: There are limited data regarding the association between socioeconomic status and risk of and outcomes after in-hospital cardiac arrest and further research is warranted. Understanding the association between socioeconomic status and in-hospital cardiac arrest may reveal strategies to mitigate potential inequalities.

Keywords: Education; Employment; In-hospital cardiac arrest; Income; Inequality; Insurance; Occupation; Poverty; Socioeconomic status.

Publication types

Review