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Sep 13, 2018

ERC congress - Resuscitation 2018

1 - Patients’ educational level influences in-hospital treatment and long-term survival in 30-day survivors of out-of-hospital cardiac arrest

OHCA

out-of-hospital cardiac arrest

education

in-hospital treatment

Survival

Abstract

Abstract

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Keywords

OHCA

out-of-hospital cardiac arrest

education

in-hospital treatment

Survival

Abstract

Purpose: Socioeconomic factors as e.g. education have been shown to influence survival from out-of-hospital cardiac arrest (OHCA), but the mechanisms remain unknown. This study examine the potential influence of patient educational level on in-hospital treatments as: initial admission to invasive heart centers, coronary angiographies, percutaneous coronary interventions (PCI), coronary artery bypass surgeries (CABG), and length of hospital admission. 2. Methods: Thirty-day survivors from OHCA of presumed cardiac cause and ≥30 years were identified from the Danish Cardiac Arrest Register, 2001-2014. The study population was divided according to last completed education (ISCED-system (<10 years, 10-12 years and >12 years of education)). Associations between educational level and in-hospital treatments as well as 1-year survival were estimated using logistic regression adjusted for age, gender and calendar year. 3. Results: In all 2,380 patients were included. 794 (33.4%) with low education, 1,074 (45.1% with medium education and 512 (21.5%) with high education. Patients with high education were associated with younger age, female gender, living in couples and less comorbidities. They were associated with significant more initial admissions to invasive heart centers (high education 68.6% vs. low 58.3%), more performed coronary angiographies overall (high education 74.4% vs. low 61.2%), acute coronary angiographies (high education 51.0% vs. low 40.2%) and higher 1-year survival (high education 94.9% vs. low 88.5%), all p<0.001. No significant differences were observed in PCI- and CABG-performance in coronary angiography-patients and length of hospital admission. After adjustment of age, gender and calendar year the observed differences between patients with high and low education remained for initial admission to invasive heart center (OR 1.47 95% CI 1.15-1.88), coronary angiography (OR 1.61 95%CI 1.25-2.07) and for 1-year survival (OR 1.73 95%CI 1.08-2.77). Patients with medium education were found in-between. 4. Conclusion: High educational level was positively associated with admission to invasive heart center, coronary angiography and 1-year survival. No difference in invasive treatments as PCI and CABG.

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All rights reserved.