Chu K, Swor R, Jackson R, Domeier R, Sadler E, Basse E, Zaleznak H, Gitlin J
Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, MI, USA.
Ann Emerg Med. 1998 Apr;31(4):478-82. doi: 10.1016/s0196-0644(98)70257-4.
To determine whether race, when controlled for income, is an independent predictor of survival to hospital discharge after out-of-hospital cardiac arrest (OHCA).
Prospective OHCA data were collected over 4 years (1991-1994) from a convenience sample of OHCA patients transported to nine hospitals in three suburban counties. Race was determined from hospital and vital statistics records. The average household income was identified from ZIP codes and used as a marker of socioeconomic status. Demographic data and known predictors of survival were compared between blacks and whites. A logistic regression analysis was used to assess the association between race, income, and survival.
Of the 1,690 patients, 223 (13%) were blacks and 1,467 (87%) were whites. Average household income was less for blacks than for whites ($40,225 versus $46,193; P < .001), but both populations were affluent by national standards (national percentile ranks were 73% and 88%, respectively). The populations were no different in percentage of witnessed arrests (57% versus 61%; P = .465). Blacks were younger (mean +/- SD, 62 +/- 16 versus 68 +/- 15 years; P < .001); less frequently received bystander CPR (11% versus 20%; P = .002); less often had ventricular tachycardia or ventricular fibrillation (37% versus 50%; P < .001); and had a shorter advanced life support call-response interval (median, 4 versus 6 minutes; P < .001). The odds ratio for survival (white/black) was .931 (95% confidence interval, .446 to 1.945).
Race was not found to predict adverse OHCA outcomes in this affluent population.
在控制收入因素的情况下，确定种族是否是院外心脏骤停（OHCA）后存活至出院的独立预测因素。
前瞻性收集了4年（1991 - 1994年）的数据，样本为转运至三个郊区县九家医院的OHCA患者，采用便利抽样法。种族信息从医院和人口统计记录中获取。通过邮政编码确定平均家庭收入，并将其作为社会经济地位的指标。比较了黑人和白人的人口统计学数据以及已知的存活预测因素。采用逻辑回归分析评估种族、收入与存活之间的关联。
1690例患者中，223例（13%）为黑人，1467例（87%）为白人。黑人的平均家庭收入低于白人（40,225美元对46,193美元；P <.001），但按照国家标准，两个群体都较为富裕（全国百分位数排名分别为73%和88%）。两个群体在目击骤停的比例上无差异（57%对61%；P =.465）。黑人更年轻（平均±标准差，62±16岁对68±15岁；P <.001）；接受旁观者心肺复苏的频率更低（11%对20%；P =.002）；发生室性心动过速或心室颤动的频率更低（37%对50%；P <.001）；高级生命支持呼叫 - 响应间隔更短（中位数，4分钟对6分钟；P <.001）。存活的优势比（白人/黑人）为0.931（95%置信区间，0.446至1.945）。
在这个富裕人群中，未发现种族是OHCA不良结局的预测因素。
