Out-of-hospital cardiac arrest: racial differences in outcome in Seattle.

Abstract

OBJECTIVES. Out-of-hospital sudden cardiac arrest is a key area in which to study the dual problem of the poorer health status of minority populations and their poorer access to the health care system. We proposed to examine the relationship between race (Black/White) and survival. METHODS. We determined the incidence and outcome of cardiac arrests in Seattle for which medical assistance was requested. RESULTS. Over a 26-month period, the age-adjusted incidence of out-of-hospital cardiac arrest was twice as great in Blacks than in Whites (3.4 vs 1.6 per 1000 aged 20 and over). The initial resuscitation rate was markedly poorer in the Black victims (17.1% vs 40.7%), and rates of survival to hospital discharge were also lower in Blacks (9.4% vs 17.1%). Both effective initial resuscitation and survival were significantly related to White race following adjustment for other covariates. CONCLUSION. The differences in outcomes were not fully explained by features of the collapse or relevant service factors. Possible explanations include delays in instituting therapy, less bystander-initiated cardiopulmonary resuscitation, poorer levels of health, and differences in the underlying cardiac disorders.

Survival After Out‐of‐Hospital Cardiac Arrest in Children

“…Our findings may differ from prior adult studies examining racial differences, given that our analysis was conducted using a more contemporary patient population as compared with many of the adult studies. Additionally, several prior studies have drawn patients from a single city or area of the country, whereas our study drew patients from a wide range of geographic locations and thus may be less susceptible to regional treatment bias 15, 17, 18. Lastly, unlike in adults where lower rates of bystander CPR among some racial groups have been implicated as a cause for worse outcomes, rates of bystander CPR in our study did not differ according to race.…”

Impact of Sex and Ethnicity on Arrhythmic Risk

“…Blacks are disproportionately affected by SCD, and the increased risk is only partially explained by the higher prevalence of important clinical risk factors of left ventricular hypertrophy and hypertension [54][55][56]. Black hypertensive patients have an increased risk of SCD compared to whites, even after adjusting for multiple other risk factors [57].…”

Racial Differences in Outcome in the Multicenter UnSustained Tachycardia Trial (MUSTT)

“…[1][2][3][4][5][6] The age-adjusted incidence of out-ofhospital cardiac arrest is higher for blacks than for whites. 1,2 The initial resuscitation rate is much poorer, and the rates of survival to hospital discharge are much lower in blacks. 1,2 Several studies have shown that blacks have disproportionately high morbidity and mortality rates with respect to cardiovascular disease.…”

“…1,2 The initial resuscitation rate is much poorer, and the rates of survival to hospital discharge are much lower in blacks. 1,2 Several studies have shown that blacks have disproportionately high morbidity and mortality rates with respect to cardiovascular disease. [3][4][5][6] Blacks have a higher mortality rate or increased risk of subsequent cardiac events after myocardial infarction than whites.…”