TY - JOUR
T1 - Ethnic disparities in out-of-hospital cardiac arrest
T2 - A population-based cohort study among adult Danish immigrants
AU - Garcia, Rodrigue
AU - Rajan, Deepthi
AU - Warming, Peder Emil
AU - Svane, Jesper
AU - Vissing, Christoffer
AU - Weeke, Peter
AU - Barcella, Carlo Alberto
AU - Jabbari, Reza
AU - Gislason, Gunnar Hilmar
AU - Torp-Pedersen, Christian
AU - Petersen, Jørgen Holm
AU - Folke, Fredrik
AU - Tfelt-Hansen, Jacob
N1 - Publisher Copyright:
© 2022 The Authors
PY - 2022
Y1 - 2022
N2 - Background: Ethnicity might impact out-of-hospital cardiac arrest (OHCA) risk, but it has scarcely been studied in Europe. We aimed to assess whether ethnicity influenced the risk of OHCA of cardiac cause in Danish immigrants and its interplay with risk factors for OHCA and socioeconomic status. Methods: This nationwide study included all immigrants between 18 and 80 years present in Denmark at some point between 2001 and 2020. Regions of origin were defined as Africa, Arabic countries, Asia, Eastern Europe, Latin America, and Western countries. OHCAs with presumed cardiac cause were identified from the Danish Cardiac Arrest Registry. Findings: Overall, among 1,011,565 immigrants, a total of 1,801 (0.2%) OHCAs (median age 64 (Q1-Q3 53–72) years, 72% males) occurred. The age- and sex- standardized (reference: Western countries) incidence of OHCA (/1,00,000 person-years) was 34.6 (27.8–43.4) in African, 34.1 (30.4–38.4) in Arabic, 33.5 (29.3–38.2) in Asian, 35.6 (31.9–39.6) in Eastern European, and 16.2 (9.0–27.2) in Latin American immigrants. When selecting Western origin as a reference, and after adjusting on OHCA risk factors, Arabic (HR 1.18, 95%CI 1.04–1.35; P=0.01), Eastern European (HR 1.28, 95%CI 1.13–1.46; P<0.001), and African origin (HR 1.34, 95%CI 1.10–1.63; P<0.01) were associated with higher risk of OHCA, whereas Latin American origin (HR 0.58, 95%CI 0.35–0.0.96; P=0.03) was associated with lower risk of OHCA. Comparable results were observed when adjusting on education level and economic status. Interpretation: This study emphasizes that ethnicity is associated with OHCA risk, even when considering traditional cardiac arrest risk factors. Funding: R Garcia received a grant from the Fédération Française de Cardiologie for his post-doctoral fellowship and this work was supported by the Novo Nordisk Foundation Tandem Programme 2022 (grant# 31364).
AB - Background: Ethnicity might impact out-of-hospital cardiac arrest (OHCA) risk, but it has scarcely been studied in Europe. We aimed to assess whether ethnicity influenced the risk of OHCA of cardiac cause in Danish immigrants and its interplay with risk factors for OHCA and socioeconomic status. Methods: This nationwide study included all immigrants between 18 and 80 years present in Denmark at some point between 2001 and 2020. Regions of origin were defined as Africa, Arabic countries, Asia, Eastern Europe, Latin America, and Western countries. OHCAs with presumed cardiac cause were identified from the Danish Cardiac Arrest Registry. Findings: Overall, among 1,011,565 immigrants, a total of 1,801 (0.2%) OHCAs (median age 64 (Q1-Q3 53–72) years, 72% males) occurred. The age- and sex- standardized (reference: Western countries) incidence of OHCA (/1,00,000 person-years) was 34.6 (27.8–43.4) in African, 34.1 (30.4–38.4) in Arabic, 33.5 (29.3–38.2) in Asian, 35.6 (31.9–39.6) in Eastern European, and 16.2 (9.0–27.2) in Latin American immigrants. When selecting Western origin as a reference, and after adjusting on OHCA risk factors, Arabic (HR 1.18, 95%CI 1.04–1.35; P=0.01), Eastern European (HR 1.28, 95%CI 1.13–1.46; P<0.001), and African origin (HR 1.34, 95%CI 1.10–1.63; P<0.01) were associated with higher risk of OHCA, whereas Latin American origin (HR 0.58, 95%CI 0.35–0.0.96; P=0.03) was associated with lower risk of OHCA. Comparable results were observed when adjusting on education level and economic status. Interpretation: This study emphasizes that ethnicity is associated with OHCA risk, even when considering traditional cardiac arrest risk factors. Funding: R Garcia received a grant from the Fédération Française de Cardiologie for his post-doctoral fellowship and this work was supported by the Novo Nordisk Foundation Tandem Programme 2022 (grant# 31364).
KW - Epidemiology
KW - Ethnicity
KW - Immigrants
KW - Out-of-Hospital Cardiac Arrest
KW - Registry
U2 - 10.1016/j.lanepe.2022.100477
DO - 10.1016/j.lanepe.2022.100477
M3 - Journal article
C2 - 35957808
AN - SCOPUS:85135718443
VL - 22
JO - The Lancet Regional Health - Europe
JF - The Lancet Regional Health - Europe
SN - 2666-7762
M1 - 100477
ER -