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Journal article
Ethnic differences in sudden cardiac arrest resuscitation
Heart (British Cardiac Society), v 102(17), pp 1363-1370
01 Sep 2016
PMID: 27117723
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective Ethnic differences in sudden cardiac arrest resuscitation have not been fully explored and studies have yielded inconsistent results. We examined the association of ethnicity with factors affecting sudden cardiac arrest outcomes.
Methods Retrospective cohort study of 3551 white, 440 black and 297 Asian sudden cardiac arrest cases in Seattle and King County, Washington, USA.
Results Compared with whites, blacks and Asians were younger, had lower socioeconomic status and were more likely to have diabetes, hypertension and end-stage renal disease (all p<0.001). Blacks and Asians were less likely to have a witnessed arrest (whites 57.6%, blacks 52.1%, Asians 46.1%, p<0.001) or receive bystander cardiopulmonary resuscitation (whites 50.9%, blacks 41.4%, Asians 47.1%, p=0.001), but had shorter average emergency medical services response time (mean in minutes: whites 5.18, blacks 4.75, Asians 4.85, p<0.001). Compared with whites, blacks were more likely to be found in pulseless electrical activity (blacks 20.9% vs whites 16.6%, p<0.001), and Asians were more likely to be found in asystole (Asians 41.1% vs whites 30.0%, p<0.001). One of the strongest predictors of resuscitation outcomes was initial cardiac rhythm with 25% of ventricular fibrillation, 4% of patients with pulseless electrical activity and 1% of patients with asystole surviving to hospital discharge (adjusted OR of resuscitation in pulseless electrical activity compared with ventricular fibrillation: 0.30, 95% CI 0.24 to 0.34, p<0.001, adjusted OR of resuscitation in asystole relative to ventricular fibrillation 0.21, 95% CI 0.17 to 0.26, p<0.001). Survival to hospital discharge was similar across all three ethnicities.
Conclusions While there were differences in some prognostic characteristics between blacks, whites and Asians, we did not detect a significant difference in survival following sudden cardiac arrest between the three ethnic groups. There was, however, an ethnic difference in presenting rhythm, with pulseless electrical activity more prevalent in blacks and asystole more prevalent in Asians.
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Details
- Title
- Ethnic differences in sudden cardiac arrest resuscitation
- Creators
- Joanna Ghobrial - University of WashingtonSusan R. Heckbert - University of WashingtonTraci M. Bartz - University of WashingtonGina Lovasi - Columbia UniversityErin Wallace - Seattle Children's Research InstituteRozenn N. Lemaitre - University of WashingtonApril F. Mohanty - Veterans Health AdministrationThomas D. Rea - University of WashingtonDavid S. Siscovick - College Station Medical CenterJean Yee - University of WashingtonM. Sue Lentz - University of WashingtonNona Sotoodehnia - University of Washington
- Publication Details
- Heart (British Cardiac Society), v 102(17), pp 1363-1370
- Publisher
- Bmj Publishing Group
- Number of pages
- 8
- Grant note
- R01 HL111089; R01 HL091244; R01 HL088576; R01 HL088456; R01 HL092111 / NHLBI NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) R01HL091244 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Web of Science ID
- WOS:000383277000007
- Scopus ID
- 2-s2.0-84965070773
- Other Identifier
- 991020100187704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems