Sherrod Charles F, Moskowitz Ari L, Kennedy Kevin F, Khan Mirza S, Mohamed Amira M, Ikemura Nobuhiro, Chan Paul S
UMKC Healthcare Institute for Innovations in Quality Kansas City MO USA.
Saint Luke's Mid America Heart Institute Kansas City MO USA.
J Am Heart Assoc. 2025 Jan 7;14(1):e037876. doi: 10.1161/JAHA.124.037876. Epub 2024 Dec 18.
Although they are fast-growing populations in the United States, little is known about survival outcomes of Hispanic and Asian patients after in-hospital cardiac arrest.
In Get With The Guidelines-Resuscitation, we identified Asian, Hispanic, and White adults with in-hospital cardiac arrest during 2005 to 2023. Using multivariable models, we compared rates of survival to discharge separately for Asian and Hispanic patients versus White patients, as well as rates of sustained return of spontaneous circulation for ≥20 minutes and favorable neurologic survival as secondary outcomes. Of 189 557 in-hospital cardiac arrests, 167 640 (88.4%), 16 800 (8.9%), and 5117 (2.7%) patients were White, Hispanic, and Asian, respectively. Compared with the survival rate to discharge for White patients (22.0%), rates were lower for Hispanic (19.4%; adjusted odds ratio [OR], 0.93 [95% CI, 0.89-0.97]; <0.001) and Asian patients (17.8%; adjusted OR, 0.90 [95% CI, 0.83-0.97]; =0.008), and these differences were attenuated after accounting for the hospital at which patients received care (adjusted OR: Hispanic patients, 0.95 [95% CI, 0.91-1.00]; Asian patients, 0.91 [95% CI, 0.84-0.99]). Although there were no differences in rates of return of spontaneous circulation between White (68.7%), Hispanic (69.0%), and Asian patients (69.7%), both Asian and Hispanic patients were less likely to have favorable neurologic survival (White: 18.3%; Hispanic: 15.4%; adjusted OR, 0.88 [95% CI, 0.84-0.93]; Asian: 13.2%; adjusted OR, 0.80 [95% CI, 0.73-0.87]). These differences were also attenuated after accounting for hospital site.
Compared with White patients, Hispanic and Asian patients with in-hospital cardiac arrest had lower rates of overall survival and favorable neurologic survival. Some of these differences were associated with the hospital at which patients received care.
尽管西班牙裔和亚裔在美国是快速增长的人口群体，但对于他们在院内心脏骤停后的生存结局却知之甚少。
在“遵循指南-复苏”项目中，我们确定了2005年至2023年期间发生院内心脏骤停的亚裔、西班牙裔和白人成年人。使用多变量模型，我们分别比较了亚裔和西班牙裔患者与白人患者的出院生存率，以及自主循环恢复持续≥20分钟的比率和良好神经功能存活作为次要结局。在189557例院内心脏骤停患者中，分别有167640例（88.4%）、16800例（8.9%）和5117例（2.7%）患者为白人、西班牙裔和亚裔。与白人患者的出院生存率（22.0%）相比，西班牙裔患者（19.4%；调整后的优势比[OR]，0.93[95%CI，0.89 - 0.97]；P<0.001）和亚裔患者（17.8%；调整后的OR，0.90[95%CI，0.83 - 0.97]；P = 0.008）的生存率较低，在考虑患者接受治疗的医院后，这些差异有所减弱（调整后的OR：西班牙裔患者，0.95[95%CI，0.91 - 1.00]；亚裔患者，0.91[95%CI，0.84 - 0.99]）。尽管白人（68.7%）、西班牙裔（69.0%）和亚裔患者（69.7%）的自主循环恢复率没有差异，但亚裔和西班牙裔患者获得良好神经功能存活的可能性均较低（白人：18.3%；西班牙裔：15.4%；调整后的OR，0.88[95%CI，0.84 - 0.93]；亚裔：13.2%；调整后的OR，0.80[95%CI，0.73 - 0.87]）。在考虑医院地点后，这些差异也有所减弱。
与白人患者相比，院内心脏骤停的西班牙裔和亚裔患者的总体生存率和良好神经功能存活率较低。其中一些差异与患者接受治疗的医院有关。
