Dr Sarah Harris1, Dr Stephen Ball1,2, Dr David Majewski1, Mr Jason Belcher1,2, Prof. Judith Finn1
1Curtin University, Perth, Australia, 2St John WA, Belmont, Australia
Biography:
Prof Judith Finn is Director of the Prehospital, Resuscitation & Emergency Care Research Unit (PRECRU) in the Curtin School of Nursing, Perth, WA – St John WA being PRECRU’s principal research parter. Judith (critical care registered nurse and epidemiologist) was the inaugural Director of the Australasian Resuscitation Outcomes Consortium (Aus-ROC).
Abstract:
Introduction
Out-of-hospital cardiac arrest (OHCA) remains a leading cause of death, yet the burden of OHCA is not shared equally across society. This study examined socioeconomic differences in the incidence of OHCA and survival outcomes among adults in Western Australia (WA).
Methods
Population-based OHCA data for patients aged 15 years and older were analysed for the period 2015-2024. Socioeconomic status (SES) was assigned using the Australian Bureau of Statistics Index of Relative Socio-Economic Disadvantage, based on patient residential address and categorised into quintiles. Crude and age-standardised incidence rates (ASIR) per 100,000 adult population were calculated. Survival outcomes were assessed for resuscitation-attempted OHCAs of medical aetiology. Incidence by SES quintiles was modelled using negative binomial linear regression, and odds of survival using logistic regression.
Results
Emergency medical services attended a total of 23,975 OHCAs in the study period, with a crude incidence of 117.34 per 100,000 population per year. A clear monotonic socioeconomic gradient was observed. As SES decreased (i.e. higher level of disadvantage), crude incidence and ASIR increased, while return of spontaneous circulation and 30-day survival declined. Incidence decreased from 193.81 per 100,000 in the most disadvantaged quintile to 73.18 per 100,000 in the least disadvantaged (p<0.001). Among resuscitation-attempted medical OHCAs, patients in the least disadvantaged quintile had 67% higher odds of 30-day survival compared with those in the most disadvantaged quintile (OR: 1.67; 95%CI: 1.28-2.18).
Conclusion
Socioeconomic disadvantage is associated with a substantially higher risk of OHCA and poorer survival outcomes, highlighting inequities in cardiac arrest.