Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.
Ethn Health. 2021 Apr;26(3):460-469. doi: 10.1080/13557858.2018.1530736. Epub 2018 Oct 10.
There are very few studies comparing epidemiology and outcomes of out-of-hospital cardiac arrest (OHCA) in different ethnic groups. Previous ethnicity studies have mostly determined OHCA differences between African American and Caucasian populations. The aim of this study was to compare epidemiology, clinical presentation, and outcomes of OHCA between the local Middle Eastern Gulf Cooperation Council (GCC) Arab and the migrant North African populations living in Qatar. This was a retrospective cohort study of Middle Eastern GCC Arabs and migrant North African patients with presumed cardiac origin OHCA resuscitated by Emergency Medical Services (EMS) in Qatar, between June 2012 and May 2015. There were 285 Middle Eastern GCC Arabs and 112 North African OHCA patients enrolled during the study period. Compared with the local GCC Arabs, univariate analysis showed that the migrant North African OHCA patients were younger and had higher odds of initial shockable rhythm, pre-hospital interventions (defibrillation and amioderone), pre-hospital scene time, and decreased odds of risk factors (hypertension, respiratory disease, and diabetes) and pre-hospital response time. The survival to hospital discharge had greater odds for North African OHCA patients which did not persist after adjustment. Multivariable logistic regression showed that North Africans were associated with lower odds of diabetes (OR 0.48, 95% CI 0.25-0.91, = 0.03), and higher odds of initial shockable rhythm (OR 2.86, 95% CI 1.30-6.33, = 0.01) and greater scene time (OR 1.02 95% CI 1.0-1.04, = 0.02). North African migrant OHCA patients were younger, had decreased risk factors and favourable OHCA rhythm and received greater ACLS interventions with shorter pre-hospital response times and longer scene times leading to better survival.
在不同种族群体中,关于院外心脏骤停(OHCA)的流行病学和结局的研究很少。以前的种族研究大多确定了非裔美国人和白种人之间的 OHCA 差异。本研究的目的是比较当地中东海湾合作委员会(GCC)阿拉伯人和居住在卡塔尔的北非移民之间 OHCA 的流行病学、临床表现和结局。这是一项回顾性队列研究,纳入了 2012 年 6 月至 2015 年 5 月期间在卡塔尔由紧急医疗服务(EMS)复苏的中东 GCC 阿拉伯人和北非移民疑似心源性 OHCA 患者。研究期间共纳入 285 例中东 GCC 阿拉伯人和 112 例北非 OHCA 患者。与当地的 GCC 阿拉伯人相比,单变量分析显示,移民北非 OHCA 患者年龄较小,初始可除颤节律、院前干预(除颤和胺碘酮)、院前现场时间的可能性更高,而高血压、呼吸疾病和糖尿病等危险因素和院前反应时间的可能性较低。北非 OHCA 患者的存活率更高,但在调整后并未持续。多变量逻辑回归显示,与北非相比,非裔美国人患糖尿病的可能性较低(OR 0.48,95%CI 0.25-0.91,P=0.03),初始可除颤节律的可能性更高(OR 2.86,95%CI 1.30-6.33,P=0.01),现场时间更长(OR 1.02 95% CI 1.0-1.04,P=0.02)。北非移民 OHCA 患者年龄较小,危险因素较少,OHCA 节律良好,接受了更多的 ACLS 干预,院前反应时间更短,现场时间更长,生存状况更好。