{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T01:33:35Z","timestamp":1794360815323,"version":"4.9.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"National Heart Foundation"},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The relationship between lower socioeconomic status (SES) and poor cardiovascular outcomes is well described; however, there exists a paucity of data exploring this association in cardiogenic shock (CS). This study aimed to investigate whether any disparities exist between SES and the incidence, quality of care or outcomes of CS patients attended by emergency medical services (EMS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This population-based cohort study included consecutive patients transported by EMS with CS between 1 January 2015 and 30 June 2019 in Victoria, Australia. Data were collected from individually linked ambulance, hospital, and mortality datasets. Patients were stratified into SES quintiles using national census data produced by the Australian Bureau of Statistics.<\/jats:p>\n                  <jats:p>A total of 2628 patients were attended by EMS for CS. The age-standardized incidence of CS amongst all patients was 11.8 [95% confidence interval (95% CI), 11.4\u201312.3] per 100\u00a0000 person-years, with a stepwise increase from the highest to lowest SES quintile (lowest quintile 17.0\u00a0vs. highest quintile 9.7 per 100\u00a0000 person-years, P-trend\u00a0&amp;lt;\u00a00.001). Patients in lower SES quintiles were less likely to attend metropolitan hospitals and more likely to be received by inner regional and remote centres without revascularization capabilities. A greater proportion of the lower SES groups presented with CS due to non-ST elevation myocardial infarction (NSTEMI) or unstable angina pectoris (UAP), and overall were less likely to undergo coronary angiography. Multivariable analysis demonstrated an increased 30-day all-cause mortality rate in the lowest three SES quintiles when compared with the highest quintile.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This population-based study demonstrated discrepancies between SES status in the incidence, care metrics, and mortality rates of patients presenting to EMS with CS. These findings outline the challenges in equitable healthcare delivery within this cohort.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcad010","type":"journal-article","created":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T00:49:25Z","timestamp":1676681365000},"page":"89-98","source":"Crossref","is-referenced-by-count":9,"title":["Association of socioeconomic status in the incidence, quality-of-care metrics, and outcomes for patients with cardiogenic shock in a pre-hospital setting"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8838-0332","authenticated-orcid":false,"given":"Jason E","family":"Bloom","sequence":"first","affiliation":[{"name":"Department of Cardiology, Alfred Health , 55 Commercial Road, Melbourne, VIC 3004 , Australia"},{"name":"Baker Heart and Diabetes Institute , 75 Commercial Road, Melbourne, VIC 3004 , Australia"},{"name":"Department of Research and Evaluation, Ambulance Victoria , 31 Joseph 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P","family":"Dawson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Alfred Health , 55 Commercial Road, Melbourne, VIC 3004 , Australia"},{"name":"Department of Research and Evaluation, Ambulance Victoria , 31 Joseph Street, Blackburn, VIC 3130 , Australia"},{"name":"School of Public Health and Preventive Medicine, Monash University , 553\u00a0St Kilda Road, Melbourne, VIC 3004 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocasta","family":"Ball","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University , 553\u00a0St Kilda Road, Melbourne, VIC 3004 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Research and Evaluation, Ambulance Victoria , 31 Joseph Street, Blackburn, VIC 3130 , Australia"},{"name":"School of Public Health and Preventive Medicine, Monash University , 553\u00a0St Kilda Road, Melbourne, VIC 3004 , Australia"},{"name":"Department of Paramedicine, Monash University , McMahons Road, Frankston, VIC 3199 , Australia"},{"name":"Department of Intensive Care, Alfred Health , 55 Commercial Road, Melbourne, VIC 3004 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley","family":"Cox","sequence":"additional","affiliation":[{"name":"Department of Research and Evaluation, Ambulance Victoria , 31 Joseph Street, Blackburn, VIC 3130 , Australia"},{"name":"School of Public Health and Preventive Medicine, Monash University , 553\u00a0St Kilda Road, Melbourne, VIC 3004 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6785-3185","authenticated-orcid":false,"given":"William","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Alfred Health , 55 Commercial Road, Melbourne, VIC 3004 , Australia"},{"name":"Baker Heart 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