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Community Disparities in Out-of-Hospital Cardiac Arrest Prehospital Antiarrhythmic Practices
Anastasia S Papin1, Hei Kit Chan2, Angela Child3
1McGovern Medical School, University of Texas Health Science Center, Houston, Texas.
Prehospital Emergency Care
|December 4, 2024
Summary
Disparities exist in out-of-hospital cardiac arrest (OHCA) treatment. Minority communities received antiarrhythmics less often and Black patients experienced longer delays, though Hispanic/Latino patients had faster administration times.
Area of Science:
- Emergency Medicine
- Public Health
- Health Disparities
Background:
- Antiarrhythmic drugs are crucial for treating out-of-hospital cardiac arrest (OHCA) with a shockable rhythm.
- Little is known about potential disparities in prehospital antiarrhythmic administration based on community demographics.
Purpose of the Study:
- To investigate the association between community race/ethnicity and prehospital antiarrhythmic administration for OHCA patients.
- To analyze disparities in both the rate and timing of antiarrhythmic administration.
Main Methods:
- A retrospective analysis of the National Emergency Medical Services Information System (NEMSIS) database (2018-2021) linked with Census data.
- Patients with shockable rhythm OHCA were stratified by ZIP code race/ethnicity (White, Black, Hispanic/Latino).
- Logistic regression and time-to-event analysis were used to compare antiarrhythmic administration rates and timing.
Main Results:
- White patients (33.0%) received antiarrhythmics more frequently than Black (28.9%) and Hispanic/Latino (27.8%) patients.
- Time to antiarrhythmic administration was longer for Black patients (median 20.5 min) compared to White (19.6 min) and Hispanic/Latino (18.0 min) patients.
- Hispanic/Latino patients experienced shorter times to antiarrhythmic administration compared to White and Black patients.
Conclusions:
- Significant disparities in prehospital antiarrhythmic administration for OHCA exist based on community race/ethnicity.
- Lower administration rates and longer administration times for Black patients highlight critical areas for intervention.
- While Hispanic/Latino patients showed faster administration times, overall disparities warrant further investigation and targeted strategies to ensure equitable care.
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