Anderson Kenton L, Saxena Monica R, Matheson Loretta W, Gautreau Marc, Brown John F, Ishoda Leo, Kohn Michael A
Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California.
Department of Emergency Medicine, University of California San Francisco School of Medicine, San Francisco, California.
Prehosp Emerg Care. 2025;29(1):30-36. doi: 10.1080/10903127.2024.2335639. Epub 2024 Apr 23.
Out-of-hospital cardiac arrest (OHCA) is a major health problem and one of the leading causes of death in adults older than 40. Multiple prior studies have demonstrated survival disparities based on race/ethnicity, but most of these focus on a single racial/ethnic group. This study evaluated OHCA variables and outcomes among on 5 racial/ethnic groups.
This is a retrospective review of data for adult patients in the Cardiac Arrest Registry to Enhance Survival (CARES) from 3 racially diverse urban counties in the San Francisco Bay Area from May 2009 to October 2021. Stratifying by 5 racial/ethnic groups, we evaluated patient survival outcomes based on patient demographics, emergency medical services response location, cardiac arrest characteristics, and hospital interventions. Adjusted risk ratios were calculated for survival to hospital discharge, controlling for sex, age, response locations, median income of response location, arrest witness, shockable rhythm, and bystander cardiopulmonary resuscitation as well as clustering by census tract.
There were 10,757 patient entries analyzed: 42% White, 24% Black, 18% Asian, 9.3% Hispanic, 6.0% Pacific Islander, 0.7% American Indian/Alaska Native, and 0.1% multiple races selected; however, only the first 5 racial/ethnic groups had sufficient numbers for comparison. The adjusted risk ratio for survival to hospital discharge was lower among the 4 racial/ethnic groups compared with the White reference group: Black (0.79, p = 0.003), Asian (0.78 p = 0.004), Hispanic (0.79, p = 0.018), and Pacific Islander (0.78, p = 0.041) groups. The risk difference for positive neurologic outcome was also lower among all 4 racial/ethnic groups compared with the White reference group.
The Black, Asian, Hispanic, and Pacific Islander groups were less likely to survive to hospital discharge from OHCA when compared with the White reference group. No variables were associated with decreased survival across any of these 4 groups.
院外心脏骤停（OHCA）是一个重大的健康问题，也是40岁以上成年人的主要死因之一。此前的多项研究已经证明了基于种族/族裔的生存差异，但其中大多数研究都集中在单一的种族/族裔群体上。本研究评估了5个种族/族裔群体中的院外心脏骤停变量和结果。
这是一项对2009年5月至2021年10月期间旧金山湾区3个种族多样化的城市县的心脏骤停登记以提高生存率（CARES）中的成年患者数据进行的回顾性分析。按5个种族/族裔群体进行分层，我们根据患者人口统计学、紧急医疗服务响应地点、心脏骤停特征和医院干预措施评估了患者的生存结果。计算了出院生存的调整风险比，对性别、年龄、响应地点、响应地点的中位数收入、骤停目击者、可电击心律、旁观者心肺复苏以及按普查区进行聚类进行了控制。
共分析了10757例患者记录：42%为白人，24%为黑人，18%为亚洲人，9.3%为西班牙裔，6.0%为太平洋岛民，0.7%为美洲印第安人/阿拉斯加原住民，0.1%为多个种族；然而，只有前5个种族/族裔群体有足够数量进行比较。与白人参照组相比，4个种族/族裔群体出院生存的调整风险比更低：黑人（0.79，p = 0.003）、亚洲人（0.78，p = 0.004）、西班牙裔（0.79,p = 0.018）和太平洋岛民（0.78,p = 0.041）群体。与白人参照组相比，所有4个种族/族裔群体中神经功能良好结果的风险差异也更低。
与白人参照组相比，黑人、亚洲人、西班牙裔和太平洋岛民群体从院外心脏骤停中出院生存的可能性较小。在这4个群体中，没有任何变量与生存率降低相关。
