Becker L B, Han B H, Meyer P M, Wright F A, Rhodes K V, Smith D W, Barrett J
Department of Medicine, University of Chicago, IL.
N Engl J Med. 1993 Aug 26;329(9):600-6. doi: 10.1056/NEJM199308263290902.
Differences between blacks and whites have been reported in the incidence of several forms of cardiovascular disease, including hypertension and stroke. We examined racial differences in the incidence of cardiac arrest in a large urban population and in subsequent survival.
We collected data on all nontraumatic, out-of-hospital cardiac arrests in Chicago from January 1, 1987, through December 31, 1988, and compared the incidence and survival rates for blacks and whites. We examined the association between survival and race and seven other known risk factors by logistic-regression analysis. We computed incidence rates by coupling our data with U.S. Census population data.
Our study population comprised 6451 patients: 3207 whites, 2910 blacks, and 334 persons of other races. The incidence of cardiac arrest was significantly higher for blacks than for whites in every age group. The survival rate after cardiac arrest was 2.6 percent in whites, as compared with 0.8 percent in blacks (P < 0.001). Blacks were significantly less likely to have a witnessed cardiac arrest, bystander-initiated cardiopulmonary resuscitation, or a "favorable" initial rhythm or to be admitted to the hospital. When they were admitted, blacks were half as likely to survive. The association between race and survival persisted even when other recognized risk factors were taken into account. We did not find important differences between blacks and whites in the response times of the emergency medical services.
The black community in our study was at higher risk for cardiac arrest and subsequent death than the white community, even after we controlled for other variables.
据报道，黑人和白人在包括高血压和中风在内的几种心血管疾病的发病率上存在差异。我们研究了大城市人群中心脏骤停的发病率以及后续生存率的种族差异。
我们收集了1987年1月1日至1988年12月31日芝加哥所有非创伤性院外心脏骤停的数据，并比较了黑人和白人的发病率及生存率。我们通过逻辑回归分析研究了生存率与种族以及其他七个已知风险因素之间的关联。我们将我们的数据与美国人口普查人口数据相结合来计算发病率。
我们的研究人群包括6451名患者：3207名白人、2910名黑人以及334名其他种族的人。在每个年龄组中，黑人心脏骤停的发病率显著高于白人。心脏骤停后的生存率在白人中为2.6%，而在黑人中为0.8%（P<0.001）。黑人发生有人目睹的心脏骤停、旁观者实施心肺复苏、出现“有利”初始心律或被送入医院的可能性显著更低。当他们被送入医院时，黑人存活的可能性只有一半。即使考虑了其他公认的风险因素，种族与生存率之间的关联仍然存在。我们没有发现黑人和白人在紧急医疗服务的响应时间上有重要差异。
在我们的研究中，即使在我们控制了其他变量之后，黑人社区发生心脏骤停及后续死亡的风险仍高于白人社区。
