Community disparities in out of hospital cardiac arrest care and outcomes in Texas

Ryan Huebinger, Veer Vithalani, Lesley Osborn, Cameron Decker, Jeff Jarvis, Robert Dickson, Mark Escott, Lynn White, Rabab Al-Araji, Peter Nikonowicz, Normandy Villa, Micah Panczyk, Henry Wang, Bentley Bobrow

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Large racial and socioeconomic inequalities exist for out-of-hospital cardiac arrest (OHCA) care and outcomes. We sought to characterize racial, ethnic, and socioeconomic disparities in OHCA care and outcomes in Texas. Methods: We analyzed 2014–2018 Texas-Cardiac Arrest Registry to Enhance Survival (CARES) data. Using census tracts, we defined race/ethnicity neighborhoods based on majority race/ethnicity composition: non-Hispanic/Latino white, non-Hispanic/Latino black, and Hispanic/Latino. We also stratified neighborhoods into socioeconomic categories: above and below the median for household income, employment rate, and high school graduation. We defined outcomes as bystander CPR rates, public bystander AED use, and survival to hospital discharge. Using mixed models, we analyzed the associations between outcomes and neighborhood (1) racial/ethnic categories and (2) socioeconomic categories. Results: We included data on 18,488 OHCAs. Relative to white neighborhoods, black neighborhoods had lower rates of AED use (OR 0.3, CI 0.2–0.4), and Hispanic/Latino neighborhoods had lower rates of bystander CPR (OR 0.7, CI 0.6–0.8), AED use (OR 0.4, CI 0.3–0.6), and survival (OR 0.8, CI 0.7–0.8). Lower income was associated with a lower rates of bystander CPR (OR 0.8, CI 0.7–0.8), AED use (OR 0.5, CI 0.4–0.8), and survival (OR 0.9, CI 0.9–0.98). Lower high school graduation was associated with a lower rate of bystander CPR (OR 0.8, CI 0.7–0.9) and AED use (OR 0.6, CI 0.4–0.9). Higher unemployment was associated with lower rates of bystander CPR (OR 0.9, CI 0.8–0.94) and AED use (OR 0.7, CI 0.5–0.99). Conclusion: Minority and poor neighborhoods in Texas experience large and unacceptable disparities in OHCA bystander response and outcomes.

Original languageEnglish (US)
Pages (from-to)101-107
Number of pages7
JournalResuscitation
Volume163
DOIs
StatePublished - Jun 2021
Externally publishedYes

Keywords

  • Cardiac arrest
  • Out-of-hospital cardiac arrest

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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