Racial and ethnic disparities in bystander resuscitation for out-of-hospital cardiac arrests

Yuting Pu; Guifang Yang; Xiangping Chai

doi:10.1016/j.hrtlng.2023.12.004

Racial and ethnic disparities in bystander resuscitation for out-of-hospital cardiac arrests

Heart Lung. 2024 Mar-Apr:64:100-106. doi: 10.1016/j.hrtlng.2023.12.004. Epub 2023 Dec 9.

Authors

Yuting Pu¹, Guifang Yang¹, Xiangping Chai²

Affiliations

¹ Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Emergency Medicine and Difficult Disease Institute, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
² Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Emergency Medicine and Difficult Disease Institute, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China. Electronic address: chaixiangping@csu.edu.cn.

PMID: 38071862
DOI: 10.1016/j.hrtlng.2023.12.004

Abstract

Introduction: Bystander-provided cardiopulmonary resuscitation (CRP) influences the survival rates of out-of-hospital cardiac arrests (OHCAs). Disparities on bystander resuscitation measures between Black, Hispanic, Asians and Non-Hispanic White OHCAs is unclear. Examining racial and ethnic differences in bystander resuscitations is essential to better target interventions.

Methods: 15,542 witnessed OHCAs were identified between April 1, 2011, and June 30, 2015 using the Resuscitation Outcomes Consortium Epidemiologic Registry 3, a multi-center, controlled trial about OHCAs in the United States and Canada. Multivariable logistic regression model was used to analyze the differences in bystander resuscitation (bystander CRP [B-CPR], CPR plus ventilation, automated external defibrillators/defibrillator application [B-AED/D], or delivery of shocks) and clinical outcomes (death at the scene or en route, return of spontaneous circulation upon first arrival at the emergency department [ROSC-ED], survival until ED discharge [S-ED], survival until hospital discharge [S-HOS], and favorable neurological outcome at discharge) between Black, Hispanic, or Asian victims and Non-Hispanic White victims.

Results: Compared to OHCA victims in Non-Hispanic Whites, Black, Hispanic, and Asians were less likely to receive B-CPR (adjusted OR: 0.79; 95 % CI: 0.63-0.99), and B-AED/D (adjusted OR: 0.80; 95 % CI: 0.65-0.98) in public locations. And, Black, Hispanic, and Asian OHCAs were less likely to receive bystander resuscitation in street/highway locations and public buildings, and less likely to have better clinical outcomes, including ROSC-ED, S-ED and S-HOS.

Conclusion: Black, Hispanic and Asian victims with witnessed OHCAs are less likely to receive bystander resuscitation and more likely to get worse outcomes than Non-Hispanic White victims.

Keywords: AED; CPR; Out-of-hospital cardiac arrest (OHCA); Racial and ethnic disparities; bystander resuscitation.

MeSH terms

Cardiopulmonary Resuscitation*
Defibrillators
Emergency Medical Services*
Emergency Service, Hospital
Humans
Logistic Models
Out-of-Hospital Cardiac Arrest* / therapy
Registries
United States / epidemiology