Out-of-hospital cardiac arrest: racial differences in outcome in Seattle.
OBJECTIVE
Out-of-hospital sudden cardiac arrest is a key area in which to study the dual problem of the poorer health status of minority populations and their poorer access to the health care system. We proposed to examine the relationship between race (Black/White) and survival.


METHODS
We determined the incidence and outcome of cardiac arrests in Seattle for which medical assistance was requested.


RESULTS
Over a 26-month period, the age-adjusted incidence of out-of-hospital cardiac arrest was twice as great in Blacks than in Whites (3.4 vs 1.6 per 1000 aged 20 and over). The initial resuscitation rate was markedly poorer in the Black victims (17.1% vs 40.7%), and rates of survival to hospital discharge were also lower in Blacks (9.4% vs 17.1%). Both effective initial resuscitation and survival were significantly related to White race following adjustment for other covariates.


CONCLUSIONS
The differences in outcomes were not fully explained by features of the collapse or relevant service factors. Possible explanations include delays in instituting therapy, less bystander-initiated cardiopulmonary resuscitation, poorer levels of health, and differences in the underlying cardiac disorders.
Cowie
M R
MR
Department of Medicine, University of Washington, Seattle.
Fahrenbruch
C E
CE
Cobb
L A
LA
Hallstrom
A P
AP
D000368:Aged; D044383:Black People; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006323:Heart Arrest / Q000208:ethnology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012151:Resuscitation / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014861:Washington / Q000453:epidemiology; D044465:White People; D001741:Black or African American