title: Association between deprivation status at community level and outcomes from out-of-hospital cardiac arrest: a nationwide observational study.
abstract: OBJECTIVE
  We sought to examine the association between area deprivation and outcomes of out-of-hospital cardiac arrest in Korea.
  
  
  METHODS
  Data were obtained from the emergency medical service (EMS) system. A nationwide OHCA cohort database from January 2006 to December 2007 was constructed via hospital chart review and ambulance run sheet data. We enrolled all EMS-assessed OHCA victims and excluded cases without available hospital outcome data or residential address. The Carstairs index was used to categorize districts according to level of deprivation into five quintiles, from (Q1, the least deprived) to (Q5, the most deprived). Main outcomes were survival to hospital discharge, survival to admission, and return of spontaneous circulation (ROSC).
  
  
  RESULTS
  34,227 patients were included. Initial rhythm, witnessed status, attempted bystander cardiopulmonary resuscitation (CPR), CPR by EMS, CPR in the emergency department (ED), and elapsed time interval significantly varied according to area deprivation level (p < 0.001). OHCA outcomes were consistently worse in the most deprived areas. The adjusted OR (95% CI) for survival to hospital discharge was 0.58 (0.45-0.77) in the most deprived areas compared to the least deprived areas.
  
  
  CONCLUSIONS
  Community deprivation was strongly associated with survival among out-of-hospital cardiac arrest patients in Korea.
authors.affiliation: Center for Education and Training of EMS and Rescue, Seoul Fire Academy, Seoul, Republic of Korea. arendt75@gmail.com
authors.forename: Ki Ok
authors.initials: KO
authors.lastname: Ahn
authors.forename: Sang Do
authors.initials: SD
authors.lastname: Shin
authors.forename: Seung Sik
authors.initials: SS
authors.lastname: Hwang
authors.forename: Juhwan
authors.initials: J
authors.lastname: Oh
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
authors.forename: Young Taek
authors.initials: YT
authors.lastname: Kim
authors.forename: Kyoung Ae
authors.initials: KA
authors.lastname: Kong
authors.forename: Sung Ok
authors.initials: SO
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality*; D056910:Republic of Korea; D012959:Socioeconomic Factors