Journal
EUROPEAN JOURNAL OF EMERGENCY MEDICINE
Volume 26, Issue 3, Pages 180-187Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MEJ.0000000000000534
Keywords
cardiac arrest; France; incidence; out-of-hospital; scan statistics; social disfavour
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Funding
- French Society of Emergency Medicine (SFMU)
- patient foundation Federation Francaise de Cardiologie
- Mutuelle Generale de l'Education Nationale (MGEN)
- University of Lille
- Institute of Health Engineering of Lille
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Objective Cardiac arrest (CA) is considered a major public health issue. Few studies have focused on geographic variations in incidence and socioeconomic characteristics. The aim of this study is to identify clusters of municipalities with high or low CA incidence, and find socioeconomic factors associated with them. Patients and methods CA data from three Parisian counties, representing 123 municipalities, were extracted from the French CA registry. Socioeconomic data for each municipality were collected from the French national institute of statistics. We used a statistical approach combining Bayesian methods to study geographical CA incidence variations, and scan statistics, to identify CA incidence clusters of municipalities. Finally, we compared clusters of municipalities in terms of socioeconomic factors. Results Strong geographical variations were found among 123 municipalities: 34 presented a significantly increased risk of incidence and 37 presented a significantly low risk. Scan statistics identified seven significant spatial clusters of CA incidence, including three clusters with low incidence (the relative risk varied from 0.23 to 0.54) and four clusters with high incidence (the relative risk varied from 1.43 to 2). Clusters of municipalities with a high CA incidence are characterized by a lower socioeconomic status than the others (low and normal CA incidence clusters). Analysis showed a statistically significant relationship between social deprivation factors and high incidence. Conclusion This study shows strong geographical variations in CA incidence and a statistically significant relationship between over-incidence and social deprivation variables. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.
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