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Racial differences in the incidence of cardiac arrest and subsequent survival. The CPR Chicago Project
L B Becker1, B H Han, P M Meyer
1Department of Medicine, University of Chicago, IL.
Insights
Blacks experienced higher cardiac arrest rates and significantly lower survival rates compared to whites. This disparity persisted even after accounting for other risk factors, highlighting a critical public health concern.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Racial disparities in cardiovascular disease, including hypertension and stroke, are documented.
- Previous research indicates potential differences in cardiovascular disease incidence and outcomes between racial groups.
Purpose of the Study:
- To investigate racial differences in the incidence of out-of-hospital cardiac arrest.
- To compare survival rates after cardiac arrest between Black and White populations.
- To identify factors associated with survival disparities in cardiac arrest patients.
Main Methods:
- Data collected on all nontraumatic, out-of-hospital cardiac arrests in Chicago (1987-1988).
- Incidence and survival rates compared between Black and White patients.
- Logistic regression analysis used to examine survival associations with race and other risk factors.
- Incidence rates calculated using U.S. Census population data.
Main Results:
- Cardiac arrest incidence was significantly higher in Black individuals across all age groups compared to White individuals.
- Survival rates post-cardiac arrest were markedly lower for Black patients (0.8%) versus White patients (2.6%).
- Black patients were less likely to have witnessed arrests, receive bystander CPR, have favorable initial rhythms, or be admitted to the hospital.
Conclusions:
- The Black community faced a higher risk of cardiac arrest and subsequent mortality compared to the White community.
- Racial disparities in cardiac arrest survival remained significant even after controlling for known risk factors.
- Further research is needed to understand and address the underlying causes of these disparities.
Background:
Differences between blacks and whites have been reported in the incidence of several forms of cardiovascular disease, including hypertension and stroke. We examined racial differences in the incidence of cardiac arrest in a large urban population and in subsequent survival.
Methods:
We collected data on all nontraumatic, out-of-hospital cardiac arrests in Chicago from January 1, 1987, through December 31, 1988, and compared the incidence and survival rates for blacks and whites. We examined the association between survival and race and seven other known risk factors by logistic-regression analysis. We computed incidence rates by coupling our data with U.S. Census population data.
Results:
Our study population comprised 6451 patients: 3207 whites, 2910 blacks, and 334 persons of other races. The incidence of cardiac arrest was significantly higher for blacks than for whites in every age group. The survival rate after cardiac arrest was 2.6 percent in whites, as compared with 0.8 percent in blacks (P < 0.001). Blacks were significantly less likely to have a witnessed cardiac arrest, bystander-initiated cardiopulmonary resuscitation, or a "favorable" initial rhythm or to be admitted to the hospital. When they were admitted, blacks were half as likely to survive. The association between race and survival persisted even when other recognized risk factors were taken into account. We did not find important differences between blacks and whites in the response times of the emergency medical services.
Conclusions:
The black community in our study was at higher risk for cardiac arrest and subsequent death than the white community, even after we controlled for other variables.