People living in deprived areas may be less likely to survive a cardiac arrest, according to new research.
The study, which involved the Hampshire and Isle of Wight Air Ambulance Research team, University of Southampton, South Central Ambulance Service and the National Institute for Health and Care Research Southampton Biomedical Research Centre, analysed ambulance data from more than 4,000 out-of-hospital cardiac arrests (OHCAs) in Hampshire.
It found that people living in deprived communities were less likely to survive for 30 days after an OHCA. The results have been published in a special edition of Resuscitation Plus and our Clinical Research page, focusing on inequality in cardiac arrest.
Researchers say the findings highlight an important issue, which could have implications for public health policy.
Health inequalities
The ambulance service in England attends more than 84,000 OHCAs a year.
Sadly, survival rates are low, with fewer than 1 in 10 people surviving and leaving hospital. For every minute that someone is in cardiac arrest without receiving CPR and early defibrillation used on them, their chance of survival decreases by 10%.
Previous research has shown that OHCAs occur most frequently in high density areas, such as inner cities. Studies have also found that bystander CPR is less common in deprived communities, which may further reduce survival rates.
Dr Jamie Plumb, Consultant Anaesthetist and our Head of Research, said:
“Across all areas of healthcare, we see differences in how patients do based on their background.
“We fairly consistently see that our most deprived communities experience worse health outcomes. This hasn’t been studied as widely in OHCA as some other areas of medicine.
“We wanted to understand how deprivation affects survival in after OHCA in Hampshire, with the hope that we could then move towards programmes to help reverse any inequality.”
Do inequalities affect survival?
The researchers examined 30-day survival rates after OHCA between 2019 and 2023. This was linked with national measurements of deprivation based on patients’ home postcodes. Patients were excluded from the analysis if their cardiac arrest was caused by trauma.
Of the 4,184 patients included in the study, 437 (10%) survived for at least 30 days.
Their analysis revealed a significant association between neighbourhood deprivation and survival.
The role of age
Survivors in the study were, on average, significantly younger than those who died. Those who survived had an average age of 62, while the average age of those who died was 71.
The data also showed that OHCA patients in deprived areas tended to be younger than those in less deprived areas.
Researchers suggest that while younger age is linked to better survival outcomes, it may mask overall health status.
Hampshire and Isle of Wight Air Ambulance Specialist Paramedic and Research team member, Peter Owen, was one of the study’s authors. He said:
“Before we accounted for other factors, we didn’t see a big difference in survival between different levels of deprivation. But once we took age into account it became clear that the outcomes, for similarly aged patients, were worse in deprived populations. It’s hard to be certain about what is driving this.
“It’s possible that these patients have more health problems than similarly aged patients from less deprived areas, and that is supported by research from other areas of healthcare.
“Further research is needed to find out why this effect exists, if it is widespread and how we can drive change.”
Visit our Clinical Research page to read a selection of our recently published papers.
