Ethnic variation for out-of-hospital cardiac arrest (OOHCA): age at event, witnessed cardiac arrest, initial arrest rhythm, response times and bystander CPR
Author . | Age, Years(mean), p value or OR . | Witnessed Arrest, p value or OR . | Initial arrest rhythm of VF/VT p value or OR . | Response Time p value or OR . | Bystander CPR, p value or OR . |
---|---|---|---|---|---|
Studies Within the US | |||||
Becker et al., 199311 | NR/NM | Black – 42% White – 49% p < 0.001 | Black – 17% White – 26% p < 0.001 | Black – 6 min White – 6 min 18-sec difference between black and white patients (p < 0.001). | Black –18% White – 25% p < 0.001 |
Cowie et al.,199341 | Black – 61.9 White – 68.2 p < 0.01 | Black – 53% White – 61% p < 0.12 | Black – VF 40%, VT 0% White – VF 49%, VT 2% p < 0.09 | Black – 3.4 min White – 3.4 min p > 0.71 | Black – 18% White – 32% p < 0.003 |
Brookoff et al., 199415 | Black – 61.9 White – 67.4 p = NR | Black – 60% White – 64% p = ns | Black – 44% White – 54% (referent) OR 0.82; 95%CI 0.73–0.93 | No statistically significant difference between blacks and whites (mean times not stated). | Black – 10% White – 21% (referent) OR 0.46 95% CI 0.34–0.61; p < 0.001. |
Chu et al., 199812 | Black – 62 White – 68 p < 0.001 | Black – 57% White – 61% p = 0.422 | Black – 37% White – 51% p < 0.01 | Black – 5.3 min White – 7.0 min p < 0.001 | Black – 11% White – 20% p = 0.003 |
Sayegh et al., 199916 | NR/NM | Black – 53% White – 56% p = 0.41 | Black – 43% White – 46% p = 0.286 | ALS ambulance response time <9 min: Black – 88% White – 83% p = 0.039 | Black – 7% White – 10% p = 0.215 |
Groeneveld et al., 200348 | Black – 76 White – 76 p = ns | NR/NM | NR/NM | NR/NM | NR/NM |
Polentini et al., 200546 | 0.56 (0.48 – 0.66), whites referent Proportions not reported | ||||
Fairbanks et al., 200720 | NR/NM | NR/NM | Black – 35% White – 29% p = 0.038 | Black – 5 min White – 5 min p = NR | NR/NM |
Galea et al., 200717 | NR/NM | Hispanic – 43% Black – 36% White – 42% p < 0.01 | Hispanic – 15% Black – 12% White – 17% p = 0.06 | Hispanic – 5 min Black – 4.7 min White – 4.5 min p < 0.01 | Hispanic – 25% Black – 31% White – 31% p < 0.01 |
Vadeboncoeur et al., 200853 | Hispanic – 53.2 Non–Hispanic – 64.5 p = 0.005 | Hispanic – 44% Non–Hispanic – 50% p = 0.074 | VF Hispanic – 21% Non-Hispanic – 27% p = 0.036 | Hispanic – 5.1 min Non-Hispanic – 5.5 min p = 0.006 | Bystander CPR Hispanic – 32% Non-Hispanic – 42% p < 0.0001 Lay Bystander CPR Hispanic – 16% Non-Hispanic – 26% p = 0.001 |
Benson et al., 200918 | Latino – 59.6 African American – 64.7 Caucasian – 69.9 p < 0.05 | Latino – 40% African American – 36% Caucasian – 48% p < 0.05 – (Caucasian vs. African American) p = ns (Caucasian vs. Latino) | Latino – 35% African American – 24% Caucasian – 31% p = ns | NR/NM | Univariate %, OR (95% CI) Latino –13%, 0.48 (0.28–0.80) African American – 13%, 0.47 (0.3–0.74) Caucasian – 24% (referent) Multivariate OR (95% CI) Latino – 0.46, 0.23–0.92 African American – 0.67, 0.38 – 1.16 |
Teodorescu et al., 201019 | NR/NM | NR/NM | Multivariate Analysis PEA vs. VF/VT, OR (95%CI): Other Race – 1.02, 0.23 – 4.59 Asian – 0.88, 0.2 – 3.98 Hispanic – 0.32, 0.05 – 2.13 Black – 2.64, 1.29 – 5.38 White – 1.0 (referent) PEA vs. Asystole – OR (95% CI): Other Race – 1.10, 0.17 – 7.05 Asian – 0.26, 0.07–1.03 Hispanic – 1.11, 0.15–8.38 Black – 1.3, 0.65–2.63 White – 1.0 (referent) | NR/NM | NR/NM |
Wilde et al., 201147 | Black – 61.1 White – 68.5 p < 0.001 | NR/NM | NR/NM | Black – 5.3 mins White – 7.3 mins p < 0.001 | Black – 72.5%† White – 80.4% p < 0.001 |
McNally et al., 201114 | NR/NM | NR/NM | NR/NM | NR/NM | Black – 32.8% White – 33.7% Hispanic – 40.2% p < 0.001 |
Merchant et al, 201154 | Blacks – 77.4* Whites – 78.1* p=0.01 | NR/NM | VF Blacks – 8%* Whites – 12%* p<0.001 | NR/NM | NR/NM |
Studies Outside the US | |||||
Hamaad et al., 200645 | Indo-Asian – 66.0 Afro–Caribbean – 63.7 Caucasian – 68.7 p = ns | NR/NM | VF Indo -Asian – 30% Afro-Caribbean – 30% Caucasian – 45% p = NR | Call to collection time (mins): Caucasian – 28.2 Afro-Caribbean – 31.7 Indo-Asian – 22.6 | NR/NM |
Shah et al., 201051 | South Asian – 64.6 White – 69.5 p < 0.005 | South Asian −70% White – 62% (referent) OR = 1.1, 95%CI 1.0 – 1.2 | South Asian – 30% White –30% (referent) OR = 1.0, 95% CI 0.7–1.3 | South Asian – 7.46 min White – 7.48 min p = 0.335 | South Asian – 30% (referent) White – 34% OR = 1.2, 95%CI, 0.9–1.7 |
Author . | Age, Years(mean), p value or OR . | Witnessed Arrest, p value or OR . | Initial arrest rhythm of VF/VT p value or OR . | Response Time p value or OR . | Bystander CPR, p value or OR . |
---|---|---|---|---|---|
Studies Within the US | |||||
Becker et al., 199311 | NR/NM | Black – 42% White – 49% p < 0.001 | Black – 17% White – 26% p < 0.001 | Black – 6 min White – 6 min 18-sec difference between black and white patients (p < 0.001). | Black –18% White – 25% p < 0.001 |
Cowie et al.,199341 | Black – 61.9 White – 68.2 p < 0.01 | Black – 53% White – 61% p < 0.12 | Black – VF 40%, VT 0% White – VF 49%, VT 2% p < 0.09 | Black – 3.4 min White – 3.4 min p > 0.71 | Black – 18% White – 32% p < 0.003 |
Brookoff et al., 199415 | Black – 61.9 White – 67.4 p = NR | Black – 60% White – 64% p = ns | Black – 44% White – 54% (referent) OR 0.82; 95%CI 0.73–0.93 | No statistically significant difference between blacks and whites (mean times not stated). | Black – 10% White – 21% (referent) OR 0.46 95% CI 0.34–0.61; p < 0.001. |
Chu et al., 199812 | Black – 62 White – 68 p < 0.001 | Black – 57% White – 61% p = 0.422 | Black – 37% White – 51% p < 0.01 | Black – 5.3 min White – 7.0 min p < 0.001 | Black – 11% White – 20% p = 0.003 |
Sayegh et al., 199916 | NR/NM | Black – 53% White – 56% p = 0.41 | Black – 43% White – 46% p = 0.286 | ALS ambulance response time <9 min: Black – 88% White – 83% p = 0.039 | Black – 7% White – 10% p = 0.215 |
Groeneveld et al., 200348 | Black – 76 White – 76 p = ns | NR/NM | NR/NM | NR/NM | NR/NM |
Polentini et al., 200546 | 0.56 (0.48 – 0.66), whites referent Proportions not reported | ||||
Fairbanks et al., 200720 | NR/NM | NR/NM | Black – 35% White – 29% p = 0.038 | Black – 5 min White – 5 min p = NR | NR/NM |
Galea et al., 200717 | NR/NM | Hispanic – 43% Black – 36% White – 42% p < 0.01 | Hispanic – 15% Black – 12% White – 17% p = 0.06 | Hispanic – 5 min Black – 4.7 min White – 4.5 min p < 0.01 | Hispanic – 25% Black – 31% White – 31% p < 0.01 |
Vadeboncoeur et al., 200853 | Hispanic – 53.2 Non–Hispanic – 64.5 p = 0.005 | Hispanic – 44% Non–Hispanic – 50% p = 0.074 | VF Hispanic – 21% Non-Hispanic – 27% p = 0.036 | Hispanic – 5.1 min Non-Hispanic – 5.5 min p = 0.006 | Bystander CPR Hispanic – 32% Non-Hispanic – 42% p < 0.0001 Lay Bystander CPR Hispanic – 16% Non-Hispanic – 26% p = 0.001 |
Benson et al., 200918 | Latino – 59.6 African American – 64.7 Caucasian – 69.9 p < 0.05 | Latino – 40% African American – 36% Caucasian – 48% p < 0.05 – (Caucasian vs. African American) p = ns (Caucasian vs. Latino) | Latino – 35% African American – 24% Caucasian – 31% p = ns | NR/NM | Univariate %, OR (95% CI) Latino –13%, 0.48 (0.28–0.80) African American – 13%, 0.47 (0.3–0.74) Caucasian – 24% (referent) Multivariate OR (95% CI) Latino – 0.46, 0.23–0.92 African American – 0.67, 0.38 – 1.16 |
Teodorescu et al., 201019 | NR/NM | NR/NM | Multivariate Analysis PEA vs. VF/VT, OR (95%CI): Other Race – 1.02, 0.23 – 4.59 Asian – 0.88, 0.2 – 3.98 Hispanic – 0.32, 0.05 – 2.13 Black – 2.64, 1.29 – 5.38 White – 1.0 (referent) PEA vs. Asystole – OR (95% CI): Other Race – 1.10, 0.17 – 7.05 Asian – 0.26, 0.07–1.03 Hispanic – 1.11, 0.15–8.38 Black – 1.3, 0.65–2.63 White – 1.0 (referent) | NR/NM | NR/NM |
Wilde et al., 201147 | Black – 61.1 White – 68.5 p < 0.001 | NR/NM | NR/NM | Black – 5.3 mins White – 7.3 mins p < 0.001 | Black – 72.5%† White – 80.4% p < 0.001 |
McNally et al., 201114 | NR/NM | NR/NM | NR/NM | NR/NM | Black – 32.8% White – 33.7% Hispanic – 40.2% p < 0.001 |
Merchant et al, 201154 | Blacks – 77.4* Whites – 78.1* p=0.01 | NR/NM | VF Blacks – 8%* Whites – 12%* p<0.001 | NR/NM | NR/NM |
Studies Outside the US | |||||
Hamaad et al., 200645 | Indo-Asian – 66.0 Afro–Caribbean – 63.7 Caucasian – 68.7 p = ns | NR/NM | VF Indo -Asian – 30% Afro-Caribbean – 30% Caucasian – 45% p = NR | Call to collection time (mins): Caucasian – 28.2 Afro-Caribbean – 31.7 Indo-Asian – 22.6 | NR/NM |
Shah et al., 201051 | South Asian – 64.6 White – 69.5 p < 0.005 | South Asian −70% White – 62% (referent) OR = 1.1, 95%CI 1.0 – 1.2 | South Asian – 30% White –30% (referent) OR = 1.0, 95% CI 0.7–1.3 | South Asian – 7.46 min White – 7.48 min p = 0.335 | South Asian – 30% (referent) White – 34% OR = 1.2, 95%CI, 0.9–1.7 |
Cohort limited to patients resuscitated from cardiac arrest and subsequently hospitalised
Refers to EMS-provided CPR and not Bystander CPR; Percentages are reported to the nearest whole number
Abbreviations: CI: confidence interval, CPR: cardiopulmonary resuscitation, NM: not measured, NR: not reported, ns: non-significant, OR: odds ratio, VF/VT – ventricular fibrillation/ventricular tachycardia ED: emergency department, EMS: emergency medical services, OOHCA: out-of-hospital cardiac arrest, PEA: pulseless electrical activity, VF/VT ventricular fibrillation/ventricular tachycardia.
Ethnic variation for out-of-hospital cardiac arrest (OOHCA): age at event, witnessed cardiac arrest, initial arrest rhythm, response times and bystander CPR
Author . | Age, Years(mean), p value or OR . | Witnessed Arrest, p value or OR . | Initial arrest rhythm of VF/VT p value or OR . | Response Time p value or OR . | Bystander CPR, p value or OR . |
---|---|---|---|---|---|
Studies Within the US | |||||
Becker et al., 199311 | NR/NM | Black – 42% White – 49% p < 0.001 | Black – 17% White – 26% p < 0.001 | Black – 6 min White – 6 min 18-sec difference between black and white patients (p < 0.001). | Black –18% White – 25% p < 0.001 |
Cowie et al.,199341 | Black – 61.9 White – 68.2 p < 0.01 | Black – 53% White – 61% p < 0.12 | Black – VF 40%, VT 0% White – VF 49%, VT 2% p < 0.09 | Black – 3.4 min White – 3.4 min p > 0.71 | Black – 18% White – 32% p < 0.003 |
Brookoff et al., 199415 | Black – 61.9 White – 67.4 p = NR | Black – 60% White – 64% p = ns | Black – 44% White – 54% (referent) OR 0.82; 95%CI 0.73–0.93 | No statistically significant difference between blacks and whites (mean times not stated). | Black – 10% White – 21% (referent) OR 0.46 95% CI 0.34–0.61; p < 0.001. |
Chu et al., 199812 | Black – 62 White – 68 p < 0.001 | Black – 57% White – 61% p = 0.422 | Black – 37% White – 51% p < 0.01 | Black – 5.3 min White – 7.0 min p < 0.001 | Black – 11% White – 20% p = 0.003 |
Sayegh et al., 199916 | NR/NM | Black – 53% White – 56% p = 0.41 | Black – 43% White – 46% p = 0.286 | ALS ambulance response time <9 min: Black – 88% White – 83% p = 0.039 | Black – 7% White – 10% p = 0.215 |
Groeneveld et al., 200348 | Black – 76 White – 76 p = ns | NR/NM | NR/NM | NR/NM | NR/NM |
Polentini et al., 200546 | 0.56 (0.48 – 0.66), whites referent Proportions not reported | ||||
Fairbanks et al., 200720 | NR/NM | NR/NM | Black – 35% White – 29% p = 0.038 | Black – 5 min White – 5 min p = NR | NR/NM |
Galea et al., 200717 | NR/NM | Hispanic – 43% Black – 36% White – 42% p < 0.01 | Hispanic – 15% Black – 12% White – 17% p = 0.06 | Hispanic – 5 min Black – 4.7 min White – 4.5 min p < 0.01 | Hispanic – 25% Black – 31% White – 31% p < 0.01 |
Vadeboncoeur et al., 200853 | Hispanic – 53.2 Non–Hispanic – 64.5 p = 0.005 | Hispanic – 44% Non–Hispanic – 50% p = 0.074 | VF Hispanic – 21% Non-Hispanic – 27% p = 0.036 | Hispanic – 5.1 min Non-Hispanic – 5.5 min p = 0.006 | Bystander CPR Hispanic – 32% Non-Hispanic – 42% p < 0.0001 Lay Bystander CPR Hispanic – 16% Non-Hispanic – 26% p = 0.001 |
Benson et al., 200918 | Latino – 59.6 African American – 64.7 Caucasian – 69.9 p < 0.05 | Latino – 40% African American – 36% Caucasian – 48% p < 0.05 – (Caucasian vs. African American) p = ns (Caucasian vs. Latino) | Latino – 35% African American – 24% Caucasian – 31% p = ns | NR/NM | Univariate %, OR (95% CI) Latino –13%, 0.48 (0.28–0.80) African American – 13%, 0.47 (0.3–0.74) Caucasian – 24% (referent) Multivariate OR (95% CI) Latino – 0.46, 0.23–0.92 African American – 0.67, 0.38 – 1.16 |
Teodorescu et al., 201019 | NR/NM | NR/NM | Multivariate Analysis PEA vs. VF/VT, OR (95%CI): Other Race – 1.02, 0.23 – 4.59 Asian – 0.88, 0.2 – 3.98 Hispanic – 0.32, 0.05 – 2.13 Black – 2.64, 1.29 – 5.38 White – 1.0 (referent) PEA vs. Asystole – OR (95% CI): Other Race – 1.10, 0.17 – 7.05 Asian – 0.26, 0.07–1.03 Hispanic – 1.11, 0.15–8.38 Black – 1.3, 0.65–2.63 White – 1.0 (referent) | NR/NM | NR/NM |
Wilde et al., 201147 | Black – 61.1 White – 68.5 p < 0.001 | NR/NM | NR/NM | Black – 5.3 mins White – 7.3 mins p < 0.001 | Black – 72.5%† White – 80.4% p < 0.001 |
McNally et al., 201114 | NR/NM | NR/NM | NR/NM | NR/NM | Black – 32.8% White – 33.7% Hispanic – 40.2% p < 0.001 |
Merchant et al, 201154 | Blacks – 77.4* Whites – 78.1* p=0.01 | NR/NM | VF Blacks – 8%* Whites – 12%* p<0.001 | NR/NM | NR/NM |
Studies Outside the US | |||||
Hamaad et al., 200645 | Indo-Asian – 66.0 Afro–Caribbean – 63.7 Caucasian – 68.7 p = ns | NR/NM | VF Indo -Asian – 30% Afro-Caribbean – 30% Caucasian – 45% p = NR | Call to collection time (mins): Caucasian – 28.2 Afro-Caribbean – 31.7 Indo-Asian – 22.6 | NR/NM |
Shah et al., 201051 | South Asian – 64.6 White – 69.5 p < 0.005 | South Asian −70% White – 62% (referent) OR = 1.1, 95%CI 1.0 – 1.2 | South Asian – 30% White –30% (referent) OR = 1.0, 95% CI 0.7–1.3 | South Asian – 7.46 min White – 7.48 min p = 0.335 | South Asian – 30% (referent) White – 34% OR = 1.2, 95%CI, 0.9–1.7 |
Author . | Age, Years(mean), p value or OR . | Witnessed Arrest, p value or OR . | Initial arrest rhythm of VF/VT p value or OR . | Response Time p value or OR . | Bystander CPR, p value or OR . |
---|---|---|---|---|---|
Studies Within the US | |||||
Becker et al., 199311 | NR/NM | Black – 42% White – 49% p < 0.001 | Black – 17% White – 26% p < 0.001 | Black – 6 min White – 6 min 18-sec difference between black and white patients (p < 0.001). | Black –18% White – 25% p < 0.001 |
Cowie et al.,199341 | Black – 61.9 White – 68.2 p < 0.01 | Black – 53% White – 61% p < 0.12 | Black – VF 40%, VT 0% White – VF 49%, VT 2% p < 0.09 | Black – 3.4 min White – 3.4 min p > 0.71 | Black – 18% White – 32% p < 0.003 |
Brookoff et al., 199415 | Black – 61.9 White – 67.4 p = NR | Black – 60% White – 64% p = ns | Black – 44% White – 54% (referent) OR 0.82; 95%CI 0.73–0.93 | No statistically significant difference between blacks and whites (mean times not stated). | Black – 10% White – 21% (referent) OR 0.46 95% CI 0.34–0.61; p < 0.001. |
Chu et al., 199812 | Black – 62 White – 68 p < 0.001 | Black – 57% White – 61% p = 0.422 | Black – 37% White – 51% p < 0.01 | Black – 5.3 min White – 7.0 min p < 0.001 | Black – 11% White – 20% p = 0.003 |
Sayegh et al., 199916 | NR/NM | Black – 53% White – 56% p = 0.41 | Black – 43% White – 46% p = 0.286 | ALS ambulance response time <9 min: Black – 88% White – 83% p = 0.039 | Black – 7% White – 10% p = 0.215 |
Groeneveld et al., 200348 | Black – 76 White – 76 p = ns | NR/NM | NR/NM | NR/NM | NR/NM |
Polentini et al., 200546 | 0.56 (0.48 – 0.66), whites referent Proportions not reported | ||||
Fairbanks et al., 200720 | NR/NM | NR/NM | Black – 35% White – 29% p = 0.038 | Black – 5 min White – 5 min p = NR | NR/NM |
Galea et al., 200717 | NR/NM | Hispanic – 43% Black – 36% White – 42% p < 0.01 | Hispanic – 15% Black – 12% White – 17% p = 0.06 | Hispanic – 5 min Black – 4.7 min White – 4.5 min p < 0.01 | Hispanic – 25% Black – 31% White – 31% p < 0.01 |
Vadeboncoeur et al., 200853 | Hispanic – 53.2 Non–Hispanic – 64.5 p = 0.005 | Hispanic – 44% Non–Hispanic – 50% p = 0.074 | VF Hispanic – 21% Non-Hispanic – 27% p = 0.036 | Hispanic – 5.1 min Non-Hispanic – 5.5 min p = 0.006 | Bystander CPR Hispanic – 32% Non-Hispanic – 42% p < 0.0001 Lay Bystander CPR Hispanic – 16% Non-Hispanic – 26% p = 0.001 |
Benson et al., 200918 | Latino – 59.6 African American – 64.7 Caucasian – 69.9 p < 0.05 | Latino – 40% African American – 36% Caucasian – 48% p < 0.05 – (Caucasian vs. African American) p = ns (Caucasian vs. Latino) | Latino – 35% African American – 24% Caucasian – 31% p = ns | NR/NM | Univariate %, OR (95% CI) Latino –13%, 0.48 (0.28–0.80) African American – 13%, 0.47 (0.3–0.74) Caucasian – 24% (referent) Multivariate OR (95% CI) Latino – 0.46, 0.23–0.92 African American – 0.67, 0.38 – 1.16 |
Teodorescu et al., 201019 | NR/NM | NR/NM | Multivariate Analysis PEA vs. VF/VT, OR (95%CI): Other Race – 1.02, 0.23 – 4.59 Asian – 0.88, 0.2 – 3.98 Hispanic – 0.32, 0.05 – 2.13 Black – 2.64, 1.29 – 5.38 White – 1.0 (referent) PEA vs. Asystole – OR (95% CI): Other Race – 1.10, 0.17 – 7.05 Asian – 0.26, 0.07–1.03 Hispanic – 1.11, 0.15–8.38 Black – 1.3, 0.65–2.63 White – 1.0 (referent) | NR/NM | NR/NM |
Wilde et al., 201147 | Black – 61.1 White – 68.5 p < 0.001 | NR/NM | NR/NM | Black – 5.3 mins White – 7.3 mins p < 0.001 | Black – 72.5%† White – 80.4% p < 0.001 |
McNally et al., 201114 | NR/NM | NR/NM | NR/NM | NR/NM | Black – 32.8% White – 33.7% Hispanic – 40.2% p < 0.001 |
Merchant et al, 201154 | Blacks – 77.4* Whites – 78.1* p=0.01 | NR/NM | VF Blacks – 8%* Whites – 12%* p<0.001 | NR/NM | NR/NM |
Studies Outside the US | |||||
Hamaad et al., 200645 | Indo-Asian – 66.0 Afro–Caribbean – 63.7 Caucasian – 68.7 p = ns | NR/NM | VF Indo -Asian – 30% Afro-Caribbean – 30% Caucasian – 45% p = NR | Call to collection time (mins): Caucasian – 28.2 Afro-Caribbean – 31.7 Indo-Asian – 22.6 | NR/NM |
Shah et al., 201051 | South Asian – 64.6 White – 69.5 p < 0.005 | South Asian −70% White – 62% (referent) OR = 1.1, 95%CI 1.0 – 1.2 | South Asian – 30% White –30% (referent) OR = 1.0, 95% CI 0.7–1.3 | South Asian – 7.46 min White – 7.48 min p = 0.335 | South Asian – 30% (referent) White – 34% OR = 1.2, 95%CI, 0.9–1.7 |
Cohort limited to patients resuscitated from cardiac arrest and subsequently hospitalised
Refers to EMS-provided CPR and not Bystander CPR; Percentages are reported to the nearest whole number
Abbreviations: CI: confidence interval, CPR: cardiopulmonary resuscitation, NM: not measured, NR: not reported, ns: non-significant, OR: odds ratio, VF/VT – ventricular fibrillation/ventricular tachycardia ED: emergency department, EMS: emergency medical services, OOHCA: out-of-hospital cardiac arrest, PEA: pulseless electrical activity, VF/VT ventricular fibrillation/ventricular tachycardia.
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