Increased mortality among acute respiratory distress patients from immigrant dense urban districts
Open Access
- 1 March 2019
- journal article
- research article
- Published by Taylor & Francis Ltd in Open Access Emergency Medicine
- Vol. ume 11, 43-49
- https://doi.org/10.2147/oaem.s187686
Abstract
Purpose: This study investigated whether living in immigrant dense urban districts (IDUDs) and low-income areas in the city of Malmö predicted 5-year mortality among patients admitted to the emergency department (ED) because of acute respiratory distress. Patients and methods: We randomly selected 184 patients with acute respiratory distress during 2007, visiting the ED at Skåne University Hospital, Malmö. In 2007, Malmö had 36% first- and second-generation immigrants. The main exposure was defined as being resident in any of the five IDUDs of Malmö compared to being resident in the five districts of Malmö with the highest proportion of Sweden-born inhabitants (SDUDs). We recorded vital parameters; medical triage priority according to Adaptive Process Triage (ADAPT), ICD-10 diagnoses, and the mean annual income for the patient’s urban district. We examined 5-year mortality risk using Cox proportional hazards model. Results: After adjustment for age and gender, patients from IDUDs (n=100, 54%) had an HR (95% CI) of 1.65 (1.087–2.494; P=0.019) regarding mortality at 5-year follow-up. Patients in the lowest vs highest income quartile had an HR of 2.00 (1.06–3.79; P=0.032) regarding mortality at 5-year follow-up. Age, male gender, presence of cardiopulmonary disease, and ADAPT priority also independently predicted the 5-year mortality. The excess risk of 5-year mortality associated with living in IDUDs remained significant after adjustment for age, gender, ADAPT priority, presence of cardiopulmonary disease, and income with an HR of 1.79 (1.15–2.78; P=0.010). Conclusion: Living in an IDUD is a strong independent risk factor for 5-year mortality in patients with acute respiratory distress. The cause is unknown. Our study suggests a need for better structured follow-up of cardiopulmonary disease in such patients.This publication has 10 references indexed in Scilit:
- A descriptive study of registered nurses’ application of the triage scale RETTS©; a Swedish reliability studyInternational Emergency Nursing, 2018
- Socioeconomic Deprivation and the Incidence of 12 Cardiovascular Diseases in 1.9 Million Women and Men: Implications for Risk Prediction and PreventionPLOS ONE, 2014
- Individual education, area income, and mortality and recurrence of myocardial infarction in a Medicare cohort: the National Longitudinal Mortality StudyBMC Public Health, 2014
- Medical Emergency Triage and Treatment System (METTS): A New Protocol in Primary Triage and Secondary Priority Decision in Emergency MedicineThe Journal of Emergency Medicine, 2011
- High prevalence of type 2 diabetes in Iraqi and Swedish residents in a deprived Swedish neighbourhood - a population based studyBMC Public Health, 2011
- Traffic-related air pollution associated with prevalence of asthma and COPD/chronic bronchitis. A cross-sectional study in Southern SwedenInternational Journal of Health Geographics, 2009
- Equal access to treatment? Population-based follow-up of drugs dispensed to patients after acute myocardial infarction in SwedenEuropean Journal of Clinical Pharmacology, 2008
- Prevalence of obstructive lung diseases and respiratory symptoms in relation to living environment and socio-economic groupRespiratory Medicine, 2001
- Intra-urban variations in incidence and mortality in myocardial infarction. A study from the myocardial infarction register in the city of Malmö, SwedenEuropean Heart Journal, 1998
- US mortality by economic, demographic, and social characteristics: the National Longitudinal Mortality Study.American Journal of Public Health, 1995