Race and Survival After Out-of-Hospital Cardiac Arrest in a Suburban Community☆,☆☆,★,★★
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INTRODUCTION
Previous studies have found that outcome after out-of-hospital cardiac arrest (OHCA) is worse for blacks than for whites.1, 2 Similarly, Valenzuela3 identified worse outcome in Hispanic-surnamed patients. These studies controlled for other factors predictive of survival but did not control for markers of socioeconomic status (SES) other than race. The goal of our research was to determine whether race, adjusted for income, is an independent predictor of survival to hospital discharge after OHCA
MATERIALS AND METHODS
A prospective, cohort study was conducted in three suburban southeastern Michigan counties with nine participating hospitals—Beyer Hospital, Chelsea Community Hospital, McPherson Hospital, North Oakland Hospital, Providence Hospital, Saline Community Hospital, St Joseph Mercy Hospital, University of Michigan Medical Center, and William Beaumont Hospital. Oakland County is a 900-square-mile area with a population of 1 million (1990 census). The EMS system is a heterogenous one- and two-tiered
RESULTS
Of the original data set of 1,963 patients, 173 (9%) were excluded because data on outcome (33 patients) or on race (90 patients) were missing, because the patient's race was non-black and non-white, or because the cardiac arrest was not of primary cardiac origin. Of the 1,690 patients remaining for univariate analysis (Table 1), 223 (13%) were blacks and 1,467 (87%) were whites.
Characteristic Blacks Whites Probability Values No. of cases
DISCUSSION
Our study found that race was not an independent predictor of survival to hospital discharge after OHCA, when adjusted for income and other predictors of outcome, in our population of affluent blacks and whites. In this study blacks had a shorter ALS call-response interval, possibly because they tend to live in the more densely populated parts of the county. Blacks had a greater proportion of OHCA occurring outside the home, a factor that favors better outcome.6
However, blacks were about half
Acknowledgements
We acknowledge Anthony Sayegh for his contribution to the data collection.
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Cited by (53)
Racial Disparity in Outcomes of Out-of-Hospital Cardiac Arrest (OHCA): A Systematic Review and Meta-Analysis
2023, Current Problems in CardiologyAssociations of Race and Ethnicity With Presentation and Outcomes of Hypertrophic Cardiomyopathy: JACC Focus Seminar 6/9
2021, Journal of the American College of CardiologyCitation Excerpt :In patients with out-of-hospital cardiac arrest, the age-adjusted incidence per 10,000 adults was 10.1 among Black subjects, 6.5 among Hispanic subjects, and 5.8 among White subjects, and age-adjusted survival to 30 days’ postdischarge was more than twice as poor for Black subjects as for White subjects (53). Several studies have shown that the prevalence of bystander cardiopulmonary resuscitation is lower for Black patients than for White patients (54,55). These studies suggest that racial/ethnic disparities in the circumstances of out-of-hospital cardiac arrest partially explain racial/ethnic disparities in survival.
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From the Departments of Emergency Medicine at William Beaumont Hospital, Royal Oak*; St Joseph's Mercy Hospital, Ann Arbor‡; William Beaumont Hospital, Troy§; North Oakland Medical Center, Pontiac∥; and Providence Hospital, Southfield, MI.¶
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Funded in part by Grant No. 92.03 from Beaumont Foundation.
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Address for reprints: Dr Robert Swor, DO, Department of Emergency Medicine, William Beaumont Hospital, 3601 West 13 Mile Road, Royal Oak, Michigan 48073, 248-551-2015, Fax 248-551-2017, E-mail [email protected]
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