In patients with low socioeconomic status, heart resuscitation is heavily delayed and, according to a recent European Heart Journal report last week, victims of cardiac arrest in hospitals are less likely to recover.

Researchers analyzed data from the national Swedish cardiopulmonary resuscitation register for 24,217 cardiac arrests in Swedish hospitals between 2005 and 2018 in patients 40 and older. They collected socioeconomic data on patients from a second database and used the highest rate of education and annual income as a socioeconomic status (SES) measure.

"The good news is that for most of the cardiac arrest cases in this study, socioeconomic status didn't seem to matter." said Professor Jens Agerström of Linnaeus University in Kalmar and Växjö, Sweden, "Nevertheless, there seems to be a significant number of deaths that can still be attributed to socioeconomic factors, even when we take account of things that could affect the results such as gender, age, ethnicity, other health conditions, cause of the cardiac arrest, and the specific hospital providing the treatment."

Patients with higher SES were slightly better controlled for heart rhythm prior to cardiac arrest. This may partly explain the survival disparities. Most unrecovered combinations between patient SES and the findings studied are minimal. A disparity in SES-related survival chances of around 21 percent shouldn't be overlooked, authors say.

Credit: European Heart Journal

The study investigated several outcomes but looking at survival for 30 days after the cardiac arrest, approximately 280 people in 1000 from a low socioeconomic background will survive; however, for patients from a high socioeconomic background approximately 320 people may survive to 30 days.

The goal of the new retrospective registry was to investigate SES inequalities in IHCA care and survival. The study looked at significant demographic, clinical, and social problems.

People with lower SES are less likely to survive a spontaneous heart arrest outside the hospital. Patients in higher-income hospitals and in school are slightly less likely. More likely to recover before hospital discharge and after heart arrest for 30 days.

"After having studied discrimination in the labour market for many years with Dr. Magnus Carlsson, one of my co-authors," said Prof. Agerström, "we thought that a natural next step would be to look at the health care system and possible treatment discrimination, which is much less researched. My own medical visits also played a role, as I got the impression that the staff often became more thorough after they had asked me about my profession."