[Kok! Health] "Long-term survival of cardiac arrest survivors depends on socioeconomic environment"

A study has found that among patients who experienced out-of-hospital cardiac arrest (OHCA), those from lower socioeconomic backgrounds have higher long-term mortality rates. The study also advises the need for proactive management accordingly.

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According to the research team led by Professors Yoo Kyungheon, Oh Jaehoon, and Cho Yongil from the Department of Emergency Medicine at Hanyang University Hospital, patients who underwent cardiac procedures after OHCA showed a 72% higher long-term mortality rate in the Medical Aid patient group.

Out-of-hospital cardiac arrest is one of the leading causes of death worldwide. Recently, there has been growing interest in the long-term prognosis of patients discharged after OHCA. Hanyang University Hospital explained that previous studies mainly focused on pre-hospital factors to improve survival rates of OHCA patients.

The research team conducted a longitudinal study tracking 4,873 patients aged 18 or older who were admitted due to OHCA and survived more than 30 days, using big data from the National Health Insurance Service from January 2005 to December 2015. Among these patients, 4,480 were registered under National Health Insurance, and 393 were registered under Medical Aid. Of these, 1,121 patients underwent cardiac procedures during hospitalization.

The study found that the long-term mortality rate of Medical Aid patients, who are presumed to have lower socioeconomic status based on income, occupation, and region, was 52% higher than that of National Health Insurance patients. In particular, Medical Aid patients who underwent cardiac procedures after OHCA had a long-term mortality rate more than 72% higher.

Professor Yoo stated, "This study is the first domestic and international comparison of long-term prognosis and mortality over more than 10 years after recovery from OHCA." He added, "Even after inpatient treatment, the long-term mortality rate remains high among socioeconomically vulnerable patients, so these patients require active management and attention after discharge. Especially, Medical Aid patients who underwent cardiac procedures need greater public health focus."

Professor Yoo continued, "The latest guidelines from the American Heart Association have added 'Recovery' as the sixth link in the chain of survival, and the latest European Resuscitation Council guidelines also emphasize recovery and rehabilitation after cardiac arrest." He suggested, "To improve long-term recovery and survival of patients who survive OHCA, multifaceted efforts to reduce socioeconomic disparities are necessary, and multidisciplinary approaches in clinical care are required."

Meanwhile, the study results were published in the July online issue of the international journal JMIR Public Health and Surveillance under the title "Association Between Socioeconomic Environment and Long-Term Survival of Out-of-Hospital Cardiac Arrest Survivors: A Nationwide Population-Based Longitudinal Study."

Professors Kyungheon Yoo, Jaehun Oh, and Yongil Cho from the Department of Emergency Medicine at Hanyang University Hospital. (From left) [Photo by Hanyang University Hospital]

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