Racial and ethnic differences in outcomes after out-of-hospital cardiac arrest: Hispanics and Blacks may fare worse than non-Hispanic Whites
This study evaluates differences in out-of-hospital cardiac arrest (OHCA) characteristics, interventions, and outcomes by race/ethnicity. This is a retrospective analysis from a regionalized cardiac system. Outcomes for all adult patients treated for OHCA with return of spontaneous circulation (ROSC...
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| Veröffentlicht in: | Resuscitation 2019-04, Vol.137, p.29-34 |
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| creator | Bosson, Nichole Fang, Andrea Kaji, Amy H. Gausche-Hill, Marianne French, William J. Shavelle, David Thomas, Joseph L. Niemann, James T. |
| description | This study evaluates differences in out-of-hospital cardiac arrest (OHCA) characteristics, interventions, and outcomes by race/ethnicity.
This is a retrospective analysis from a regionalized cardiac system. Outcomes for all adult patients treated for OHCA with return of spontaneous circulation (ROSC) were identified from 2011–2014. Stratifying by race/ethnicity with White as the reference group, patient characteristics, treatment, and outcomes were evaluated. The adjusted odds ratios (OR) for survival with good neurologic outcome (cerebral performance category 1 or 2) were calculated.
There were 5178 patients with OHCA; 290 patients excluded for unknown race, leaving 4888 patients: 50% White, 14% Black, 12% Asian, 23% Hispanic. In univariate analysis, compared with Whites, Blacks had fewer witnessed arrests (83% vs 86%, p = 0.03) and less bystander CPR (37% vs 44%, p = 0.005), were less likely to undergo coronary angiography (14% vs 22%, p |
| doi_str_mv | 10.1016/j.resuscitation.2019.01.038 |
| format | Article |
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This is a retrospective analysis from a regionalized cardiac system. Outcomes for all adult patients treated for OHCA with return of spontaneous circulation (ROSC) were identified from 2011–2014. Stratifying by race/ethnicity with White as the reference group, patient characteristics, treatment, and outcomes were evaluated. The adjusted odds ratios (OR) for survival with good neurologic outcome (cerebral performance category 1 or 2) were calculated.
There were 5178 patients with OHCA; 290 patients excluded for unknown race, leaving 4888 patients: 50% White, 14% Black, 12% Asian, 23% Hispanic. In univariate analysis, compared with Whites, Blacks had fewer witnessed arrests (83% vs 86%, p = 0.03) and less bystander CPR (37% vs 44%, p = 0.005), were less likely to undergo coronary angiography (14% vs 22%, p < 0.0001), and less likely to receive PCI (32% vs 54%, p < 0.0001). Asians presented less often with a shockable rhythm (27% vs 34%, p = 0.001) and were less likely to undergo angiography (15% vs 22%, p < 0.0001). Hispanics presented less often with a shockable rhythm (31% vs 34%, p = 0.03), had fewer witnessed arrests (82% vs 86%, p = 0.001) and less bystander CPR (37% vs 44%, p = 0.0001). In multivariable analysis, Hispanic ethnicity was associated with decreased favorable neurologic outcome (OR 0.78 [95%CI 0.63–0.96]). Outcomes for Asians and Blacks did not differ from Whites. When accounting for clustering by hospital, race was no longer statistically significantly associated with survival with good neurologic outcome.
We identified important differences in patients with OHCA according to race/ethnicity. Such differences may have implications for interventions; for example, emphasis on bystander CPR instruction in Black and Hispanic communities.</description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/j.resuscitation.2019.01.038</identifier><identifier>PMID: 30753852</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>African Americans - statistics & numerical data ; Aged ; Aged, 80 and over ; Cardiopulmonary arrest ; Cardiopulmonary Resuscitation ; Coronary Angiography ; Ethnicity ; European Continental Ancestry Group - statistics & numerical data ; Female ; Hispanic Americans - statistics & numerical data ; Humans ; Los Angeles ; Male ; Middle Aged ; Out-of-Hospital Cardiac Arrest - ethnology ; Out-of-Hospital Cardiac Arrest - mortality ; Out-of-Hospital Cardiac Arrest - therapy ; Outcome Assessment, Health Care ; Percutaneous Coronary Intervention ; Race ; Retrospective Studies ; Survival Analysis</subject><ispartof>Resuscitation, 2019-04, Vol.137, p.29-34</ispartof><rights>2019 Elsevier B.V.</rights><rights>Copyright © 2019 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c383t-b0884c26fc018bd49d3ecac7dcfb44ea5e0896e36c5fe3a1dba88691f97b1e873</citedby><cites>FETCH-LOGICAL-c383t-b0884c26fc018bd49d3ecac7dcfb44ea5e0896e36c5fe3a1dba88691f97b1e873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.resuscitation.2019.01.038$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30753852$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bosson, Nichole</creatorcontrib><creatorcontrib>Fang, Andrea</creatorcontrib><creatorcontrib>Kaji, Amy H.</creatorcontrib><creatorcontrib>Gausche-Hill, Marianne</creatorcontrib><creatorcontrib>French, William J.</creatorcontrib><creatorcontrib>Shavelle, David</creatorcontrib><creatorcontrib>Thomas, Joseph L.</creatorcontrib><creatorcontrib>Niemann, James T.</creatorcontrib><title>Racial and ethnic differences in outcomes after out-of-hospital cardiac arrest: Hispanics and Blacks may fare worse than non-Hispanic Whites</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description>This study evaluates differences in out-of-hospital cardiac arrest (OHCA) characteristics, interventions, and outcomes by race/ethnicity.
This is a retrospective analysis from a regionalized cardiac system. Outcomes for all adult patients treated for OHCA with return of spontaneous circulation (ROSC) were identified from 2011–2014. Stratifying by race/ethnicity with White as the reference group, patient characteristics, treatment, and outcomes were evaluated. The adjusted odds ratios (OR) for survival with good neurologic outcome (cerebral performance category 1 or 2) were calculated.
There were 5178 patients with OHCA; 290 patients excluded for unknown race, leaving 4888 patients: 50% White, 14% Black, 12% Asian, 23% Hispanic. In univariate analysis, compared with Whites, Blacks had fewer witnessed arrests (83% vs 86%, p = 0.03) and less bystander CPR (37% vs 44%, p = 0.005), were less likely to undergo coronary angiography (14% vs 22%, p < 0.0001), and less likely to receive PCI (32% vs 54%, p < 0.0001). Asians presented less often with a shockable rhythm (27% vs 34%, p = 0.001) and were less likely to undergo angiography (15% vs 22%, p < 0.0001). Hispanics presented less often with a shockable rhythm (31% vs 34%, p = 0.03), had fewer witnessed arrests (82% vs 86%, p = 0.001) and less bystander CPR (37% vs 44%, p = 0.0001). In multivariable analysis, Hispanic ethnicity was associated with decreased favorable neurologic outcome (OR 0.78 [95%CI 0.63–0.96]). Outcomes for Asians and Blacks did not differ from Whites. When accounting for clustering by hospital, race was no longer statistically significantly associated with survival with good neurologic outcome.
We identified important differences in patients with OHCA according to race/ethnicity. Such differences may have implications for interventions; for example, emphasis on bystander CPR instruction in Black and Hispanic communities.</description><subject>African Americans - statistics & numerical data</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiopulmonary arrest</subject><subject>Cardiopulmonary Resuscitation</subject><subject>Coronary Angiography</subject><subject>Ethnicity</subject><subject>European Continental Ancestry Group - statistics & numerical data</subject><subject>Female</subject><subject>Hispanic Americans - statistics & numerical data</subject><subject>Humans</subject><subject>Los Angeles</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Out-of-Hospital Cardiac Arrest - ethnology</subject><subject>Out-of-Hospital Cardiac Arrest - mortality</subject><subject>Out-of-Hospital Cardiac Arrest - therapy</subject><subject>Outcome Assessment, Health Care</subject><subject>Percutaneous Coronary Intervention</subject><subject>Race</subject><subject>Retrospective Studies</subject><subject>Survival Analysis</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU9rFTEUxYNY7LP6FSTgxs2MyWT-ZHRlS7VCQRDFZbiT3PDynEmeSaal38EPbZ6vFdx1lQR-99yTcwh5zVnNGe_f7uqIaU3aZcgu-LphfKwZr5mQT8iGy0FUvBvYU7JhgrFq7IbmlDxPaccYE904PCOngg2dkF2zIb-_gnYwU_CGYt56p6lx1mJErzFR52lYsw5LuYPNGA_PKthqG9K-GJiphmgcaAqxuMrv6JVLeygy6a_k-Qz6Z6IL3FELEeltiAlp3oKnPvjqAaY_ti5jekFOLMwJX96fZ-T7x8tvF1fV9ZdPny8-XFdaSJGriUnZ6qa3mnE5mXY0AjXowWg7tS1Ch0yOPYpedxYFcDOBlP3I7ThMHEs-Z-TNUXcfw6-12FaLSxrnGTyGNamGS9G3Y895Qd8fUR1DShGt2ke3QLxTnKlDHWqn_qtDHepQjKtSR5l-db9onRY0_2Yf8i_A5RHA8t0bh1EVoUP0xkXUWZngHrXoD7h-p1A</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>Bosson, Nichole</creator><creator>Fang, Andrea</creator><creator>Kaji, Amy H.</creator><creator>Gausche-Hill, Marianne</creator><creator>French, William J.</creator><creator>Shavelle, David</creator><creator>Thomas, Joseph L.</creator><creator>Niemann, James T.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201904</creationdate><title>Racial and ethnic differences in outcomes after out-of-hospital cardiac arrest: Hispanics and Blacks may fare worse than non-Hispanic Whites</title><author>Bosson, Nichole ; Fang, Andrea ; Kaji, Amy H. ; Gausche-Hill, Marianne ; French, William J. ; Shavelle, David ; Thomas, Joseph L. ; Niemann, James T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c383t-b0884c26fc018bd49d3ecac7dcfb44ea5e0896e36c5fe3a1dba88691f97b1e873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>African Americans - statistics & numerical data</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiopulmonary arrest</topic><topic>Cardiopulmonary Resuscitation</topic><topic>Coronary Angiography</topic><topic>Ethnicity</topic><topic>European Continental Ancestry Group - statistics & numerical data</topic><topic>Female</topic><topic>Hispanic Americans - statistics & numerical data</topic><topic>Humans</topic><topic>Los Angeles</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Out-of-Hospital Cardiac Arrest - ethnology</topic><topic>Out-of-Hospital Cardiac Arrest - mortality</topic><topic>Out-of-Hospital Cardiac Arrest - therapy</topic><topic>Outcome Assessment, Health Care</topic><topic>Percutaneous Coronary Intervention</topic><topic>Race</topic><topic>Retrospective Studies</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bosson, Nichole</creatorcontrib><creatorcontrib>Fang, Andrea</creatorcontrib><creatorcontrib>Kaji, Amy H.</creatorcontrib><creatorcontrib>Gausche-Hill, Marianne</creatorcontrib><creatorcontrib>French, William J.</creatorcontrib><creatorcontrib>Shavelle, David</creatorcontrib><creatorcontrib>Thomas, Joseph L.</creatorcontrib><creatorcontrib>Niemann, James T.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bosson, Nichole</au><au>Fang, Andrea</au><au>Kaji, Amy H.</au><au>Gausche-Hill, Marianne</au><au>French, William J.</au><au>Shavelle, David</au><au>Thomas, Joseph L.</au><au>Niemann, James T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Racial and ethnic differences in outcomes after out-of-hospital cardiac arrest: Hispanics and Blacks may fare worse than non-Hispanic Whites</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>2019-04</date><risdate>2019</risdate><volume>137</volume><spage>29</spage><epage>34</epage><pages>29-34</pages><issn>0300-9572</issn><eissn>1873-1570</eissn><abstract>This study evaluates differences in out-of-hospital cardiac arrest (OHCA) characteristics, interventions, and outcomes by race/ethnicity.
This is a retrospective analysis from a regionalized cardiac system. Outcomes for all adult patients treated for OHCA with return of spontaneous circulation (ROSC) were identified from 2011–2014. Stratifying by race/ethnicity with White as the reference group, patient characteristics, treatment, and outcomes were evaluated. The adjusted odds ratios (OR) for survival with good neurologic outcome (cerebral performance category 1 or 2) were calculated.
There were 5178 patients with OHCA; 290 patients excluded for unknown race, leaving 4888 patients: 50% White, 14% Black, 12% Asian, 23% Hispanic. In univariate analysis, compared with Whites, Blacks had fewer witnessed arrests (83% vs 86%, p = 0.03) and less bystander CPR (37% vs 44%, p = 0.005), were less likely to undergo coronary angiography (14% vs 22%, p < 0.0001), and less likely to receive PCI (32% vs 54%, p < 0.0001). Asians presented less often with a shockable rhythm (27% vs 34%, p = 0.001) and were less likely to undergo angiography (15% vs 22%, p < 0.0001). Hispanics presented less often with a shockable rhythm (31% vs 34%, p = 0.03), had fewer witnessed arrests (82% vs 86%, p = 0.001) and less bystander CPR (37% vs 44%, p = 0.0001). In multivariable analysis, Hispanic ethnicity was associated with decreased favorable neurologic outcome (OR 0.78 [95%CI 0.63–0.96]). Outcomes for Asians and Blacks did not differ from Whites. When accounting for clustering by hospital, race was no longer statistically significantly associated with survival with good neurologic outcome.
We identified important differences in patients with OHCA according to race/ethnicity. Such differences may have implications for interventions; for example, emphasis on bystander CPR instruction in Black and Hispanic communities.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>30753852</pmid><doi>10.1016/j.resuscitation.2019.01.038</doi><tpages>6</tpages></addata></record> |
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| subjects | African Americans - statistics & numerical data Aged Aged, 80 and over Cardiopulmonary arrest Cardiopulmonary Resuscitation Coronary Angiography Ethnicity European Continental Ancestry Group - statistics & numerical data Female Hispanic Americans - statistics & numerical data Humans Los Angeles Male Middle Aged Out-of-Hospital Cardiac Arrest - ethnology Out-of-Hospital Cardiac Arrest - mortality Out-of-Hospital Cardiac Arrest - therapy Outcome Assessment, Health Care Percutaneous Coronary Intervention Race Retrospective Studies Survival Analysis |
| title | Racial and ethnic differences in outcomes after out-of-hospital cardiac arrest: Hispanics and Blacks may fare worse than non-Hispanic Whites |
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