The impact of socioeconomic status on paediatric out-of-hospital cardiac arrest incidence and outcomes in Western Australia: a population-based cohort study.
Resuscitation Plus · 2026-06-01 · Registry study
Abstract
AIM: To assess differences in incidence, patient characteristics, and survival outcomes by socioeconomic status [SES] in paediatric out-of-hospital cardiac arrest [pOHCA]. METHODS: OHCA patients aged <15 years attended by emergency medical services [EMS] in Western Australia [WA] between 2015 and 2024 were identified. SES was classified using the Australian Bureau of Statistics Index of Relative Socio-Economic Disadvantage. SES was assigned based on each patient's residential address and categorised according to WA population-based tertiles (Low, Mid, High). Crude and age-standardised incidence rates per 100,000 population per year were calculated for all pOHCA. Incidence was modelled using negative binomial regression, stratified by SES tertile and paediatric age-group (infant, young child, older child). Survival outcomes (return of spontaneous circulation at hospital arrival [ROSC] and 30-day survival) were descriptively reported by SES tertile. RESULTS: A total of 411 pOHCAs attended by EMS were eligible for inclusion. The crude incidence of pOHCA was 9.03 per 100,000 population per year. Nearly half of all events (n = 201; 48.9%) occurred in children residing in low-SES areas (most disadvantaged). Incidence decreased with increasing socioeconomic advantage. The magnitude of the socioeconomic gradient differed by age (interaction p = 0.015) and was most pronounced in infancy. Overall, 11.7% of children achieved ROSC and 30-day survival was 7.8%, with no consistent socioeconomic differences observed. CONCLUSION: Socioeconomic disadvantage is strongly associated with higher pOHCA incidence, with the gradient most pronounced in early life. These findings highlight the need to better understand the mechanisms underpinning these disparities.
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Tags
Children · Equity & disparities · Mortality & survival
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