Community Variations in Out-of-Hospital Cardiac Arrest Care and Outcomes in Texas

Area of Science:

• Emergency Medicine
• Public Health
• Cardiology

Background:

• Significant variations in cardiac resuscitation care and outcomes exist across communities.
• Texas, a populous state, exhibits diverse community and emergency response infrastructures.
• The Texas-CARES registry provides a platform for analyzing out-of-hospital cardiac arrest (OHCA) in Texas.

Purpose of the Study:

• To conduct the first statewide analysis of OHCA in Texas using the Texas-CARES registry.
• To evaluate variations in OHCA incidence, care, and outcomes across Texas communities.
• To identify disparities in bystander CPR, AED use, and survival rates.

Main Methods:

• Analysis of the Texas-CARES registry for adult, non-traumatic OHCAs from 2014-2018.
• Stratification of OHCA care and outcomes by community.
• Use of mixed models to assess variations in bystander CPR, AED use, and survival, adjusting for covariates.

Main Results:

• A total of 26,847 OHCAs were analyzed across 13 communities.
• Overall Texas OHCA characteristics: bystander CPR (43.3%), bystander AED use (9.1%), survival to discharge (9.1%).
• Wide variations observed in bystander CPR (19.2%-55.0%), AED use (0%-19.5%), and survival (6.7%-14.0%) across communities.

Conclusions:

• Texas OHCA care and outcomes are generally similar to national averages.
• Significant inter-community variations in bystander CPR, AED use, and survival were identified.
• These disparities highlight opportunities to enhance OHCA care and improve survival rates statewide.