ArticleJAMA network open2025
Rurality and Area Deprivation and Outcomes After Out-of-Hospital Cardiac Arrest.
Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Differences in the rates of bystander cardiopulmonary resuscitation for out-of-hospital cardiac arrest resulting in favourable neurological outcomes according to the regional deprivation index.Resuscitation plus · 2026Article
- Out-of-hospital cardiac arrest incidence and temporal trends in Ecuador: a national cross-sectional study.Resuscitation plus · 2026Article
- Practice variability of epinephrine administration in pediatric out-of-hospital cardiac arrest in the United States.Resuscitation plus · 2026Article
- Spatial heterogeneity in risk-adjusted return of spontaneous circulation after out-of-hospital cardiac arrest: the urbanization-adjusted RACA model.BMC emergency medicine · 2026Article
- Geographic variation in blood transfusion among TRICARE beneficiaries.Transfusion · 2026Article
- Understanding the impact of socioeconomic deprivation on inpatient surgical care delivery costs in the Veterans Health Administration.Social sciences & humanities open · 2026Article
- Underuse of bystander defibrillation on females during out-of-hospital cardiac arrest: a retrospective observational study in Aotearoa New Zealand.Resuscitation plus · 2026Article
- Association of municipal rurality and area deprivation with cause-specific mortality in Japan: a nationwide ecological study.BMJ public health · 2026Article
- CPR knowledge among rural grassroots healthcare workers in Xinjiang, China: a cross-sectional analysis.Frontiers in medicine · 2025Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Large regional variations in outcomes after out-of-hospital cardiac arrest (OHCA) exist. Objective: To assess whether neighborhood rurality or economic deprivation where an OHCA occurred is associated with variation in emergency medical services (EMS) outcomes after OHCA. Design, Setting, and Participants: This cohort study used data collated by ESO Inc on US adult patients (aged ≥18 years) with nontraumatic OHCA receiving chest compressions or defibrillation from EMS between January 1, 2022, and December 31, 2023. Exposures: Rurality was assessed using Rural-Urban Commuting Area codes. Deprivation was assessed using the Area Deprivation Index. Both were derived from US Census data and grouped by EMS agency. Main Outcomes and Measures: Outcomes were restoration of spontaneous circulation (ROSC) at emergency department (ED) arrival, survival to hospital discharge, and favorable discharge destination. Discharge outcomes were only available for patients transported to hospitals using health data exchange. Generalized estimating equations were used to account for correlated data. Results: A total of 162 289 patients with OHCA had resuscitation attempted (median [IQR] age, 66 [53-76] years; 62.3% male). Overall, 28.1% of these patients lived in rural or suburban locations, 12.3% lived in areas with high deprivation, 18.7% had a first rhythm of ventricular tachycardia or ventricular fibrillation or shockable by automated external defibrillator rhythm, and 27.6% received bystander cardiopulmonary resuscitation. The mean (SD) EMS response time was 8.7 (5.6) minutes. Upon arrival at the ED, 23.7% of patients had ROSC. Compared with OHCAs in urban areas with low deprivation, those in rural areas with high deprivation (adjusted odds ratio [AOR], 0.81; 95% CI, 0.72-0.91), moderate deprivation (AOR, 0.75; 95% CI, 0.70-0.81), or low deprivation (AOR, 0.74; 95% CI, 0.62-0.88) had lower odds of ROSC at ED arrival. Among patients transported to hospitals using health data exchange, OHCAs in urban areas with high or moderate deprivation had lower odds of survival (AOR, 0.78 [95% CI, 0.68-0.90] and 0.82 [95% CI, 0.75-0.89], respectively) and favorable discharge destination (AOR, 0.65 [95% CI, 0.53-0.79] and 0.77 [95% CI, 0.69-0.87], respectively). Conclusions and Relevance: In this cohort study, OHCAs in rural areas of all levels of economic deprivation were associated with less ROSC at ED arrival vs urban areas with low deprivation, and OHCAs in urban areas with high or moderate deprivation are associated with less survival and less favorable discharge destination, suggesting worse neurologic outcomes. Care improvements alone may not reduce geographic differences in outcomes after OHCA.
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