Ethnic differences in sudden cardiac arrest resuscitation.
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.



Retrospective cohort study of 3551 white, 440 black and 297 Asian sudden cardiac arrest cases in Seattle and King County, Washington, USA.



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.



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.
Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA Department of Cardiology, University of California, Los Angeles, California, USA.
Joanna
J
Ghobrial
Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, Washington, USA.
Susan R
SR
Heckbert
Cardiovascular Health Research Unit and Department of Biostatistics, University of Washington, Seattle, Washington, USA.
Traci M
TM
Bartz
Columbia University, New York, New York, USA.
Gina
G
Lovasi
Seattle Children's Research Institute, Seattle, Washington, USA.
Erin
E
Wallace
Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA.
Rozenn N
RN
Lemaitre
Salt Lake City Veteran's Affairs, Salt Lake City, Utah, USA.
April F
AF
Mohanty
University of Washington, Seattle, Washington, USA.
Thomas D
TD
Rea
New York Academy of Medicine, New York, New York, USA.
David S
DS
Siscovick
Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA.
Jean
J
Yee
Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA.
M Sue
MS
Lentz
Cardiovascular Health Research Unit, Division of Cardiology, University of Washington, Seattle, Washington, USA.
Nona
N
Sotoodehnia
D001741:Black or African American; D000367:Age Factors; D001213:Asian; D015897:Comorbidity; D016757:Death, Sudden, Cardiac / Q000208:ethnology* / Q000517:prevention & control*; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology*; D017052:Hospital Mortality / Q000208:ethnology; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000208:ethnology* / Q000401:mortality / Q000628:therapy*; D010351:Patient Discharge; D015995:Prevalence; D012151:Resuscitation / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D044465:White People