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

Am J Public Health. 1993 Jul;83(7):955-9. doi: 10.2105/ajph.83.7.955.

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • African Continental Ancestry Group*
  • Aged
  • Emergency Medical Services / statistics & numerical data*
  • European Continental Ancestry Group
  • Female
  • Health Services Accessibility
  • Heart Arrest / ethnology*
  • Heart Arrest / mortality
  • Heart Arrest / therapy
  • Humans
  • Male
  • Middle Aged
  • Resuscitation / statistics & numerical data
  • Treatment Outcome*
  • Washington / epidemiology