Ethnic variation in survival following out-of-hospital cardiac arrest (OOHCA)
| Author . | Survival to Hospital Admission . | Survival to Hospital Discharge . | Other Survival End Points . |
|---|---|---|---|
| Studies Within US | |||
| Wilcox-Gok, 198544 | Black – 12% White –18% p value/OR not stated§ | Black – 6% Whits – 5% p value/OR not stated§ | NR/NM |
| Becker et al., 199311 | Black – 6% White – 11% p < 0.001 | Black – 13% White – 25% p = 0.001 | Overall survival Black – 1% White – 3% p < 0.001 |
| Cowie et al.,199341 | Black (referent) – 17% White – 40% p < 0.001 OR 3.48 (2.08 – 5.82) | Black (referent)– 9% White – 17% p < 0.03 OR 2.15 (1.11 – 4.17) | Logistic regression, OR (95% CI), (Black, referent) Initial resuscitation – 4.05, 2.25–7.28 Hospital discharge without major neurological disability – 2.64, 1.15–6.07. |
| Brookoff et al., 199415 | Black – 22% White – 29% (referent) OR 0.75, 95% CI 0.61–0.93 | Black – 7% White – 9% p = ns | Survival with no neurological deficit Black – 5% White – 6%, p = ns |
| Chu et al., 199812 | Black – 17% White – 20% p value/OR – NR | Black – 6% White – 7% (referent) Multivariate analysis OR 0.931, 95% CI 0.446–1.945 | NR/NM |
| Lindholm et al., 199850 | NR/NM | NR/NM | Pre hospital survival No difference between race† and survival* (OR 0.77, 95% CI, 0.54–1.08, p = 0.13) |
| Sweeney et al., 199852 | NR/NM | No difference between white and black subjects (p = 0.735) Percentage/numbers by ethnicity not provided | NR/NM |
| Sayegh et al., 199916 | NR/NM | Univariate analysis Black 3% White 6% p = 0.034 Multivariate analysis Adjusted OR = 1.39; 95% CI – 0.65 – 2.97 | NR/NM |
| Groeneveld et al., 200348 | NR/NM | NR/NM | Long term survival following discharge Unadjusted life expectancy Black – 1.9 years White – 4.1 years p < 0.0001 Multivariate analyses (White referent) Adjusted for demographic, clinical and hospital factors Age 66–74 – HR 1.3, 95% CI 1.09–1.55, p = 0.003 Age ≥ 75 – HR 0.88, 95% CI 0.74–1.06, p = 0.18 |
| Polentini et al., 200546 | No difference (p value/OR not stated). | No difference (p value/OR not stated). | NR/NM |
| Fairbanks et al., 200720 | NR/NM | NR/NM | Survival to 1 yr Black 4% White 6% p = 0.67 |
| Galea et al., 200717 | Hispanic – 9% Black – 6% White – 11% p < 0.01 | Hispanic – 2% Black –1% White – 3% p < 0.01 | 30 day survival to hospital discharge Univariate analysis Hispanic – 2% Black – 1% White – 3% p < 0.01 Multivariate analysis – no statistical difference in 30-day survival and ethnicity. |
| Vadeboncoeur et al., 200853 | NR/NM | Multivariate analysis: OR adjusted for age, sex, bystander CPR, witnessed arrest, VF, and interval from EMS dispatch to arrival time Hispanic – 8% Non-Hispanic – 7% (Referent) OR 1.2; 95% CI 0.7–2.1 | NR/NM |
| Liu et al., 20084 || | NR/NM | African American – 35% (Referent) White – 30% OR 0.79, 95% CI 0.62 – 1.0; p = 0.053 | NR/NM |
| Benson et al., 200918 | NR/NM | Hispanic – 5% African American – 3% White – 6%, p = ns | NR/NM |
| Wilde et al., 201147 | NR/NM | NR/NM | Pre-hospital survival (ROSC rates) Univariate Analysis Black – 20% White – 26% OR = 0.69, 95% CI 0.53 –0.91; p = 0.007 Multivariate Analysis: adjusted for age, sex, characteristics prior to cardiac arrest, pre-hospital event factors, patient zip code and agency fixed effects OR = 0.71, 95% CI 0.50 –1.01 |
| McNally et al., 201114 | NR/NM | Hispanic/Latino – 9.4% Black/African American – 8% White – 10% p value/OR not stated | NR/NM |
| Merchant et al., 201154|| | NR/NM | Unadjusted survival at discharge White – 33%* Black – 30%* p < 0.001 Note: cohort limited to surviving patients following cardiac arrest and hospitalisation | NR/NM |
| Studies outside US | |||
| Lim et al., 200249 | NR/NM | NR/NM | No difference between racial distribution and survival‡ (p = 0.93) |
| Shah et al., 201051 | South Asian – 23% White – 22% OR = 0.98, 95% CI, 0.98–0.99) | South Asian – 9% White – 9% OR = 0.98, 95% CI, 0.98 – 1.00 | NR/NM |
| Author . | Survival to Hospital Admission . | Survival to Hospital Discharge . | Other Survival End Points . |
|---|---|---|---|
| Studies Within US | |||
| Wilcox-Gok, 198544 | Black – 12% White –18% p value/OR not stated§ | Black – 6% Whits – 5% p value/OR not stated§ | NR/NM |
| Becker et al., 199311 | Black – 6% White – 11% p < 0.001 | Black – 13% White – 25% p = 0.001 | Overall survival Black – 1% White – 3% p < 0.001 |
| Cowie et al.,199341 | Black (referent) – 17% White – 40% p < 0.001 OR 3.48 (2.08 – 5.82) | Black (referent)– 9% White – 17% p < 0.03 OR 2.15 (1.11 – 4.17) | Logistic regression, OR (95% CI), (Black, referent) Initial resuscitation – 4.05, 2.25–7.28 Hospital discharge without major neurological disability – 2.64, 1.15–6.07. |
| Brookoff et al., 199415 | Black – 22% White – 29% (referent) OR 0.75, 95% CI 0.61–0.93 | Black – 7% White – 9% p = ns | Survival with no neurological deficit Black – 5% White – 6%, p = ns |
| Chu et al., 199812 | Black – 17% White – 20% p value/OR – NR | Black – 6% White – 7% (referent) Multivariate analysis OR 0.931, 95% CI 0.446–1.945 | NR/NM |
| Lindholm et al., 199850 | NR/NM | NR/NM | Pre hospital survival No difference between race† and survival* (OR 0.77, 95% CI, 0.54–1.08, p = 0.13) |
| Sweeney et al., 199852 | NR/NM | No difference between white and black subjects (p = 0.735) Percentage/numbers by ethnicity not provided | NR/NM |
| Sayegh et al., 199916 | NR/NM | Univariate analysis Black 3% White 6% p = 0.034 Multivariate analysis Adjusted OR = 1.39; 95% CI – 0.65 – 2.97 | NR/NM |
| Groeneveld et al., 200348 | NR/NM | NR/NM | Long term survival following discharge Unadjusted life expectancy Black – 1.9 years White – 4.1 years p < 0.0001 Multivariate analyses (White referent) Adjusted for demographic, clinical and hospital factors Age 66–74 – HR 1.3, 95% CI 1.09–1.55, p = 0.003 Age ≥ 75 – HR 0.88, 95% CI 0.74–1.06, p = 0.18 |
| Polentini et al., 200546 | No difference (p value/OR not stated). | No difference (p value/OR not stated). | NR/NM |
| Fairbanks et al., 200720 | NR/NM | NR/NM | Survival to 1 yr Black 4% White 6% p = 0.67 |
| Galea et al., 200717 | Hispanic – 9% Black – 6% White – 11% p < 0.01 | Hispanic – 2% Black –1% White – 3% p < 0.01 | 30 day survival to hospital discharge Univariate analysis Hispanic – 2% Black – 1% White – 3% p < 0.01 Multivariate analysis – no statistical difference in 30-day survival and ethnicity. |
| Vadeboncoeur et al., 200853 | NR/NM | Multivariate analysis: OR adjusted for age, sex, bystander CPR, witnessed arrest, VF, and interval from EMS dispatch to arrival time Hispanic – 8% Non-Hispanic – 7% (Referent) OR 1.2; 95% CI 0.7–2.1 | NR/NM |
| Liu et al., 20084 || | NR/NM | African American – 35% (Referent) White – 30% OR 0.79, 95% CI 0.62 – 1.0; p = 0.053 | NR/NM |
| Benson et al., 200918 | NR/NM | Hispanic – 5% African American – 3% White – 6%, p = ns | NR/NM |
| Wilde et al., 201147 | NR/NM | NR/NM | Pre-hospital survival (ROSC rates) Univariate Analysis Black – 20% White – 26% OR = 0.69, 95% CI 0.53 –0.91; p = 0.007 Multivariate Analysis: adjusted for age, sex, characteristics prior to cardiac arrest, pre-hospital event factors, patient zip code and agency fixed effects OR = 0.71, 95% CI 0.50 –1.01 |
| McNally et al., 201114 | NR/NM | Hispanic/Latino – 9.4% Black/African American – 8% White – 10% p value/OR not stated | NR/NM |
| Merchant et al., 201154|| | NR/NM | Unadjusted survival at discharge White – 33%* Black – 30%* p < 0.001 Note: cohort limited to surviving patients following cardiac arrest and hospitalisation | NR/NM |
| Studies outside US | |||
| Lim et al., 200249 | NR/NM | NR/NM | No difference between racial distribution and survival‡ (p = 0.93) |
| Shah et al., 201051 | South Asian – 23% White – 22% OR = 0.98, 95% CI, 0.98–0.99) | South Asian – 9% White – 9% OR = 0.98, 95% CI, 0.98 – 1.00 | NR/NM |
Survival denoted successful resuscitation at the primary cardiac arrest site
Study does not specify which racial group is compared to Black
Survival denoted successful Emergency Department resuscitation
Percentages derived from cohort numbers
Survival at hospital discharge compared by ethnic group in a cohort already admitted to hospital following OOHCA
Percentages are reported to the nearest whole number
Abbreviations: CI: confidence interval, CPR: cardiopulmonary resuscitation, NR: not reported, NM: not measured, ns: not significant, OR: odds ratio, OOHCA: out-of-hospital cardiac arrest, ROSC: return of spontaneous circulation, EMS: Emergency Medical Service, VF: ventricular fibrillation.
Ethnic variation in survival following out-of-hospital cardiac arrest (OOHCA)
| Author . | Survival to Hospital Admission . | Survival to Hospital Discharge . | Other Survival End Points . |
|---|---|---|---|
| Studies Within US | |||
| Wilcox-Gok, 198544 | Black – 12% White –18% p value/OR not stated§ | Black – 6% Whits – 5% p value/OR not stated§ | NR/NM |
| Becker et al., 199311 | Black – 6% White – 11% p < 0.001 | Black – 13% White – 25% p = 0.001 | Overall survival Black – 1% White – 3% p < 0.001 |
| Cowie et al.,199341 | Black (referent) – 17% White – 40% p < 0.001 OR 3.48 (2.08 – 5.82) | Black (referent)– 9% White – 17% p < 0.03 OR 2.15 (1.11 – 4.17) | Logistic regression, OR (95% CI), (Black, referent) Initial resuscitation – 4.05, 2.25–7.28 Hospital discharge without major neurological disability – 2.64, 1.15–6.07. |
| Brookoff et al., 199415 | Black – 22% White – 29% (referent) OR 0.75, 95% CI 0.61–0.93 | Black – 7% White – 9% p = ns | Survival with no neurological deficit Black – 5% White – 6%, p = ns |
| Chu et al., 199812 | Black – 17% White – 20% p value/OR – NR | Black – 6% White – 7% (referent) Multivariate analysis OR 0.931, 95% CI 0.446–1.945 | NR/NM |
| Lindholm et al., 199850 | NR/NM | NR/NM | Pre hospital survival No difference between race† and survival* (OR 0.77, 95% CI, 0.54–1.08, p = 0.13) |
| Sweeney et al., 199852 | NR/NM | No difference between white and black subjects (p = 0.735) Percentage/numbers by ethnicity not provided | NR/NM |
| Sayegh et al., 199916 | NR/NM | Univariate analysis Black 3% White 6% p = 0.034 Multivariate analysis Adjusted OR = 1.39; 95% CI – 0.65 – 2.97 | NR/NM |
| Groeneveld et al., 200348 | NR/NM | NR/NM | Long term survival following discharge Unadjusted life expectancy Black – 1.9 years White – 4.1 years p < 0.0001 Multivariate analyses (White referent) Adjusted for demographic, clinical and hospital factors Age 66–74 – HR 1.3, 95% CI 1.09–1.55, p = 0.003 Age ≥ 75 – HR 0.88, 95% CI 0.74–1.06, p = 0.18 |
| Polentini et al., 200546 | No difference (p value/OR not stated). | No difference (p value/OR not stated). | NR/NM |
| Fairbanks et al., 200720 | NR/NM | NR/NM | Survival to 1 yr Black 4% White 6% p = 0.67 |
| Galea et al., 200717 | Hispanic – 9% Black – 6% White – 11% p < 0.01 | Hispanic – 2% Black –1% White – 3% p < 0.01 | 30 day survival to hospital discharge Univariate analysis Hispanic – 2% Black – 1% White – 3% p < 0.01 Multivariate analysis – no statistical difference in 30-day survival and ethnicity. |
| Vadeboncoeur et al., 200853 | NR/NM | Multivariate analysis: OR adjusted for age, sex, bystander CPR, witnessed arrest, VF, and interval from EMS dispatch to arrival time Hispanic – 8% Non-Hispanic – 7% (Referent) OR 1.2; 95% CI 0.7–2.1 | NR/NM |
| Liu et al., 20084 || | NR/NM | African American – 35% (Referent) White – 30% OR 0.79, 95% CI 0.62 – 1.0; p = 0.053 | NR/NM |
| Benson et al., 200918 | NR/NM | Hispanic – 5% African American – 3% White – 6%, p = ns | NR/NM |
| Wilde et al., 201147 | NR/NM | NR/NM | Pre-hospital survival (ROSC rates) Univariate Analysis Black – 20% White – 26% OR = 0.69, 95% CI 0.53 –0.91; p = 0.007 Multivariate Analysis: adjusted for age, sex, characteristics prior to cardiac arrest, pre-hospital event factors, patient zip code and agency fixed effects OR = 0.71, 95% CI 0.50 –1.01 |
| McNally et al., 201114 | NR/NM | Hispanic/Latino – 9.4% Black/African American – 8% White – 10% p value/OR not stated | NR/NM |
| Merchant et al., 201154|| | NR/NM | Unadjusted survival at discharge White – 33%* Black – 30%* p < 0.001 Note: cohort limited to surviving patients following cardiac arrest and hospitalisation | NR/NM |
| Studies outside US | |||
| Lim et al., 200249 | NR/NM | NR/NM | No difference between racial distribution and survival‡ (p = 0.93) |
| Shah et al., 201051 | South Asian – 23% White – 22% OR = 0.98, 95% CI, 0.98–0.99) | South Asian – 9% White – 9% OR = 0.98, 95% CI, 0.98 – 1.00 | NR/NM |
| Author . | Survival to Hospital Admission . | Survival to Hospital Discharge . | Other Survival End Points . |
|---|---|---|---|
| Studies Within US | |||
| Wilcox-Gok, 198544 | Black – 12% White –18% p value/OR not stated§ | Black – 6% Whits – 5% p value/OR not stated§ | NR/NM |
| Becker et al., 199311 | Black – 6% White – 11% p < 0.001 | Black – 13% White – 25% p = 0.001 | Overall survival Black – 1% White – 3% p < 0.001 |
| Cowie et al.,199341 | Black (referent) – 17% White – 40% p < 0.001 OR 3.48 (2.08 – 5.82) | Black (referent)– 9% White – 17% p < 0.03 OR 2.15 (1.11 – 4.17) | Logistic regression, OR (95% CI), (Black, referent) Initial resuscitation – 4.05, 2.25–7.28 Hospital discharge without major neurological disability – 2.64, 1.15–6.07. |
| Brookoff et al., 199415 | Black – 22% White – 29% (referent) OR 0.75, 95% CI 0.61–0.93 | Black – 7% White – 9% p = ns | Survival with no neurological deficit Black – 5% White – 6%, p = ns |
| Chu et al., 199812 | Black – 17% White – 20% p value/OR – NR | Black – 6% White – 7% (referent) Multivariate analysis OR 0.931, 95% CI 0.446–1.945 | NR/NM |
| Lindholm et al., 199850 | NR/NM | NR/NM | Pre hospital survival No difference between race† and survival* (OR 0.77, 95% CI, 0.54–1.08, p = 0.13) |
| Sweeney et al., 199852 | NR/NM | No difference between white and black subjects (p = 0.735) Percentage/numbers by ethnicity not provided | NR/NM |
| Sayegh et al., 199916 | NR/NM | Univariate analysis Black 3% White 6% p = 0.034 Multivariate analysis Adjusted OR = 1.39; 95% CI – 0.65 – 2.97 | NR/NM |
| Groeneveld et al., 200348 | NR/NM | NR/NM | Long term survival following discharge Unadjusted life expectancy Black – 1.9 years White – 4.1 years p < 0.0001 Multivariate analyses (White referent) Adjusted for demographic, clinical and hospital factors Age 66–74 – HR 1.3, 95% CI 1.09–1.55, p = 0.003 Age ≥ 75 – HR 0.88, 95% CI 0.74–1.06, p = 0.18 |
| Polentini et al., 200546 | No difference (p value/OR not stated). | No difference (p value/OR not stated). | NR/NM |
| Fairbanks et al., 200720 | NR/NM | NR/NM | Survival to 1 yr Black 4% White 6% p = 0.67 |
| Galea et al., 200717 | Hispanic – 9% Black – 6% White – 11% p < 0.01 | Hispanic – 2% Black –1% White – 3% p < 0.01 | 30 day survival to hospital discharge Univariate analysis Hispanic – 2% Black – 1% White – 3% p < 0.01 Multivariate analysis – no statistical difference in 30-day survival and ethnicity. |
| Vadeboncoeur et al., 200853 | NR/NM | Multivariate analysis: OR adjusted for age, sex, bystander CPR, witnessed arrest, VF, and interval from EMS dispatch to arrival time Hispanic – 8% Non-Hispanic – 7% (Referent) OR 1.2; 95% CI 0.7–2.1 | NR/NM |
| Liu et al., 20084 || | NR/NM | African American – 35% (Referent) White – 30% OR 0.79, 95% CI 0.62 – 1.0; p = 0.053 | NR/NM |
| Benson et al., 200918 | NR/NM | Hispanic – 5% African American – 3% White – 6%, p = ns | NR/NM |
| Wilde et al., 201147 | NR/NM | NR/NM | Pre-hospital survival (ROSC rates) Univariate Analysis Black – 20% White – 26% OR = 0.69, 95% CI 0.53 –0.91; p = 0.007 Multivariate Analysis: adjusted for age, sex, characteristics prior to cardiac arrest, pre-hospital event factors, patient zip code and agency fixed effects OR = 0.71, 95% CI 0.50 –1.01 |
| McNally et al., 201114 | NR/NM | Hispanic/Latino – 9.4% Black/African American – 8% White – 10% p value/OR not stated | NR/NM |
| Merchant et al., 201154|| | NR/NM | Unadjusted survival at discharge White – 33%* Black – 30%* p < 0.001 Note: cohort limited to surviving patients following cardiac arrest and hospitalisation | NR/NM |
| Studies outside US | |||
| Lim et al., 200249 | NR/NM | NR/NM | No difference between racial distribution and survival‡ (p = 0.93) |
| Shah et al., 201051 | South Asian – 23% White – 22% OR = 0.98, 95% CI, 0.98–0.99) | South Asian – 9% White – 9% OR = 0.98, 95% CI, 0.98 – 1.00 | NR/NM |
Survival denoted successful resuscitation at the primary cardiac arrest site
Study does not specify which racial group is compared to Black
Survival denoted successful Emergency Department resuscitation
Percentages derived from cohort numbers
Survival at hospital discharge compared by ethnic group in a cohort already admitted to hospital following OOHCA
Percentages are reported to the nearest whole number
Abbreviations: CI: confidence interval, CPR: cardiopulmonary resuscitation, NR: not reported, NM: not measured, ns: not significant, OR: odds ratio, OOHCA: out-of-hospital cardiac arrest, ROSC: return of spontaneous circulation, EMS: Emergency Medical Service, VF: ventricular fibrillation.
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