背景:小儿院外心脏骤停(POHCA)与显著的死亡率和不良的神经系统预后相关。我们旨在描述安大略省社会人口统计学因素与POHCA风险之间的关联,加拿大。方法和结果我们在ICES进行了全省病例对照研究,其中患者记录跨管理数据库链接。病例组包括2004年至2020年期间经历OHCA的儿童(1天至17岁)。对照在年龄上匹配到1:4,性别,索引日期,和关键的合并症。我们使用条件逻辑回归来衡量社会人口统计学指标与POHCA风险之间的关系。病例组和对照组包括1,826名和7,254名儿童,分别。生活在物质匮乏程度最高的地区(调整后的比值比[aOR]:2.35,95%CI:1.94,2.85)和依赖性(aOR:1.22,95%CI:1.01,1.48)的儿童患POHCA的比值较高,相对于生活在物质匮乏和依赖程度最低的地区的儿童,分别。生活在种族多样性水平最低的社区中的儿童患POHCA的几率更高(aOR:1.62,95%CI:1.30,2.01),相对于生活在种族多样性水平最高的社区的儿童。POHCA在移民中的几率较低(OR:0.67,95%CI:0.47,0.95),相对于普通人群。北部城市住宅(aOR:1.45,95%CI:1.13,1.87)与POHCA的较高几率相关,相对于南方城市居住。结论生活在高度边缘化社区的儿童可能有更高的POHCA风险。这些发现强调了通过有针对性的预防和干预努力解决差距的重要性。
BACKGROUND: Pediatric out-of-hospital cardiac arrest (POHCA) is associated with significant mortality and poor neurological outcomes. We aimed to describe the association between sociodemographic factors and POHCA risk in Ontario, Canada.
RESULTS: We conducted a province-wide
case-control study at ICES, where patient records are linked across administrative databases. The
case group included children (aged 1 day to 17 years) who experienced an out-of-hospital cardiac arrest between 2004 and 2020. Controls were matched up to 1:4 on age, sex, index date, and key comorbidities. We used conditional logistic regression to measure the association between sociodemographic indicators and POHCA risk. The
case and control groups included 1826 and 7254 children, respectively. Children living in areas with the highest levels of material deprivation (adjusted odds ratio [aOR], 2.35 [95% CI, 1.94-2.85]) and dependency (aOR, 1.22 [95% CI, 1.01-1.48]) had a higher odds of POHCA, relative to children living in regions with the lowest levels of material deprivation and dependency, respectively. Children living in neighborhoods with the lowest levels of ethnic diversity had a higher odds of POHCA (aOR, 1.62 [95% CI, 1.30-2.01]), relative to children living in neighborhoods with the highest levels of ethnic diversity. The odds of POHCA were lower in immigrants (aOR, 0.67 [95% CI, 0.47-0.95]), relative to the general population. Northern urban residence was associated with a higher odds of POHCA (aOR, 1.45 [95% CI, 1.13-1.87]), relative to southern urban residence.
CONCLUSIONS: Children living in neighborhoods with high levels of marginalization may have an elevated risk of experiencing POHCA. These findings highlight the importance of addressing disparities through targeted prevention and intervention efforts.