Cowie M R, Fahrenbruch C E, Cobb L A, Hallstrom A P
Department of Medicine, University of Washington, Seattle.
Am J Public Health. 1993 Jul;83(7):955-9. doi: 10.2105/ajph.83.7.955.
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.
We determined the incidence and outcome of cardiac arrests in Seattle for which medical assistance was requested.
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.
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.
院外心脏骤停是一个关键领域，可用于研究少数族裔健康状况较差及其获得医疗保健系统机会较少这一双重问题。我们提议研究种族（黑人/白人）与生存率之间的关系。
我们确定了西雅图市请求医疗救助的心脏骤停的发病率和结局。
在26个月的时间里，年龄调整后的院外心脏骤停发病率黑人是白人的两倍（每1000名20岁及以上人群中分别为3.4例和1.6例）。黑人受害者的初始复苏率明显较低（17.1%对40.7%），黑人出院生存率也较低（9.4%对17.1%）。在对其他协变量进行调整后，有效的初始复苏和生存率均与白人种族显著相关。
结局差异不能完全由晕倒特征或相关服务因素来解释。可能的解释包括治疗延迟、旁观者发起的心肺复苏较少、健康水平较差以及潜在心脏疾病的差异。
