Background:Despite the acknowledged importance of socioeconomic factors as regards cardiovascular disease onset and survival, the relationship between individual-level socioeconomic factors and survival after out-of-hospital cardiac arrest is not established. Our aim was to investigate whether socioeconomic variables are associated with 30-day survival after out-of-hospital cardiac arrest.Methods:We linked data from the Swedish Registry for Cardiopulmonary Resuscitation with individual-level data on socioeconomic factors (ie, educational level and disposable income) from Statistics Sweden. Confounding and mediating variables included demographic factors, comorbidity, and Utstein resuscitation variables. Outcome was 30-day survival. Multiple modified Poisson regression was used for the main analyses.Results:A total of 31 373 out-of-hospital cardiac arrests occurring in 2010 to 2017 were included. Crude 30-day survival rates by income quintiles were as follows: Q1 (low), 414/6277 (6.6%); Q2, 339/6276 (5.4%); Q3, 423/6275 (6.7%); Q4, 652/6273 (10.4%); and Q5 (high), 928/6272 (14.8%). In adjusted analysis, the chance of survival by income level followed a gradient-like increase, with a risk ratio of 1.86 (95% CI, 1.65–2.09) in the highest-income quintile versus the lowest. This association remained after adjusting for comorbidity, resuscitation factors, and initial rhythm. A higher educational level was associated with improved 30-day survival, with the risk ratio associated with postsecondary education ≥4 years being 1.51 (95% CI, 1.30–1.74). Survival disparities by income and educational level were observed in both men and women.Conclusions:In this nationwide observational study using individual-level socioeconomic data, higher income and higher educational level were associated with better 30-day survival after out-of-hospital cardiac arrest in both sexes.

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收入和教育的不平等与院外心脏骤停后的生存差异有关：全国观察研究

背景：尽管社会经济因素对心血管疾病的发病和生存具有公认的重要性，但个体水平的社会经济因素与院外心脏骤停后生存率之间的关系尚未确定。我们的目的是调查社会经济变量是否与院外心脏骤停后的 30 天生存率相关。方法：我们将瑞典心肺复苏登记处的数据与社会经济因素（即教育水平和可支配收入）来自瑞典统计局。混杂和中介变量包括人口统计学因素、合并症和 Utstein 复苏变量。结果是 30 天的生存期。主要分析采用多元修正泊松回归。结果：共纳入 2010 年至 2017 年发生的 31 373 例院外心脏骤停。按收入五分位数划分的粗略 30 天生存率如下：第一季度（低），414/6277（6.6%）；第二季度，339/6276（5.4%）；第三季度，423/6275（6.7%）；第四季度，652/6273（10.4%）；和 Q5（高），928/6272（14.8%）。在调整后的分析中，收入水平的生存机会呈梯度增加，最高收入五分之一与最低收入的风险比为 1.86（95% CI，1.65-2.09）。在调整合并症、复苏因素和初始节律后，这种关联仍然存在。较高的教育水平与改善的 30 天生存率相关，与中学后教育≥4 年相关的风险比为 1.51（95% CI，1.30-1.74）。在男性和女性中观察到收入和教育水平的生存差异。结论：