Cardiac arrest & resuscitation
Rurality and Area Deprivation and Outcomes After Out-of-Hospital Cardiac Arrest
Authors' conclusion
In this cohort study, OHCAs in rural areas of all levels of economic deprivation were associated with less ROSC at ED arrival vs urban areas with low deprivation, and OHCAs in urban areas with high or moderate deprivation are associated with less survival and less favorable discharge destination, suggesting worse neurologic outcomes.
Study context
- Population
- US adults (≥18 years) with nontraumatic out-of-hospital cardiac arrest (OHCA) receiving chest compressions or defibrillation from emergency medical services (EMS), 2022–2023 (ESO Inc data)resuscitation attempted
- Participants
- 162,289 adults
- Exposure
- Rurality and area deprivation categories vs urban areas with low deprivation
- Outcome
- ROSC at ED arrival, survival to hospital discharge, and favorable discharge destination
Methodological detailsmulticentre registry, generalized estimating equations
- Multicentre registry
- Generalized estimating equations
Main finding
As reported in the abstract
ROSC at ED arrival
Each group vs urban, low deprivationAOR for ROSC at ED arrival (95% CI)
Rural, high deprivation
0.81(0.72–0.91)
Rural, moderate deprivation
0.75(0.70–0.81)
Rural, low deprivation
0.74(0.62–0.88)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Survival to hospital discharge (patients transported to hospitals using health data exchange)Urban, high deprivation vs Urban, low deprivation | aOR for survival to hospital discharge 0.78 (95% CI 0.68–0.90) | |
| Survival to hospital discharge (patients transported to hospitals using health data exchange)Urban, moderate deprivation vs Urban, low deprivation | aOR for survival to hospital discharge 0.82 (95% CI 0.75–0.89) | |
| Favorable discharge destination (patients transported to hospitals using health data exchange)Urban, high deprivation vs Urban, low deprivation | aOR for favorable discharge destination 0.65 (95% CI 0.53–0.79) | |
| Favorable discharge destination (patients transported to hospitals using health data exchange)Urban, moderate deprivation vs Urban, low deprivation | aOR for favorable discharge destination 0.77 (95% CI 0.69–0.87) | |
| 0.512Ratio (log scale) |
Original publication
Rurality and Area Deprivation and Outcomes After Out-of-Hospital Cardiac Arrest. JAMA Netw Open. Published 1 April 2025. doi:10.
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