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American Journal of Public Health logoLink to American Journal of Public Health
. 1993 Jul;83(7):955–959. doi: 10.2105/ajph.83.7.955

Out-of-hospital cardiac arrest: racial differences in outcome in Seattle.

M R Cowie 1, C E Fahrenbruch 1, L A Cobb 1, A P Hallstrom 1
PMCID: PMC1694759  PMID: 8328616

Abstract

OBJECTIVES. Out-of-hospital sudden cardiac arrest is a key area in which to study the dual problem of the poorer health status of minority populations and their poorer access to the health care system. We proposed to examine the relationship between race (Black/White) and survival. METHODS. We determined the incidence and outcome of cardiac arrests in Seattle for which medical assistance was requested. RESULTS. Over a 26-month period, the age-adjusted incidence of out-of-hospital cardiac arrest was twice as great in Blacks than in Whites (3.4 vs 1.6 per 1000 aged 20 and over). The initial resuscitation rate was markedly poorer in the Black victims (17.1% vs 40.7%), and rates of survival to hospital discharge were also lower in Blacks (9.4% vs 17.1%). Both effective initial resuscitation and survival were significantly related to White race following adjustment for other covariates. CONCLUSION. The differences in outcomes were not fully explained by features of the collapse or relevant service factors. Possible explanations include delays in instituting therapy, less bystander-initiated cardiopulmonary resuscitation, poorer levels of health, and differences in the underlying cardiac disorders.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blendon R. J., Aiken L. H., Freeman H. E., Corey C. R. Access to medical care for black and white Americans. A matter of continuing concern. JAMA. 1989 Jan 13;261(2):278–281. [PubMed] [Google Scholar]
  2. Cobb L. A., Hallstrom A. P. Community-based cardiopulmonary resuscitation: what have we learned? Ann N Y Acad Sci. 1982;382:330–342. doi: 10.1111/j.1749-6632.1982.tb55228.x. [DOI] [PubMed] [Google Scholar]
  3. Cooper R. S., Simmons B., Castaner A., Prasad R., Franklin C., Ferlinz J. Survival rates and prehospital delay during myocardial infarction among black persons. Am J Cardiol. 1986 Feb 1;57(4):208–211. doi: 10.1016/0002-9149(86)90892-1. [DOI] [PubMed] [Google Scholar]
  4. Keil J. E., Saunders D. E., Jr, Lackland D. T., Weinrich M. C., Hudson M. B., Gastright J. A., Baroody N. B., O'Bryan E. C., Jr, Zmyslinski R. W. Acute myocardial infarction: period prevalence, case fatality, and comparison of black and white cases in urban and rural areas of South Carolina. Am Heart J. 1985 Apr;109(4):776–784. doi: 10.1016/0002-8703(85)90638-6. [DOI] [PubMed] [Google Scholar]
  5. Simmons B. E., Castaner A., Campo A., Ferlinz J., Mar M., Cooper R. Coronary artery disease in blacks of lower socioeconomic status: angiographic findings from the Cook County Hospital Heart Disease Registry. Am Heart J. 1988 Jul;116(1 Pt 1):90–97. doi: 10.1016/0002-8703(88)90254-2. [DOI] [PubMed] [Google Scholar]
  6. Weaver W. D., Cobb L. A., Hallstrom A. P., Fahrenbruch C., Copass M. K., Ray R. Factors influencing survival after out-of-hospital cardiac arrest. J Am Coll Cardiol. 1986 Apr;7(4):752–757. doi: 10.1016/s0735-1097(86)80332-1. [DOI] [PubMed] [Google Scholar]
  7. Weaver W. D., Hill D., Fahrenbruch C. E., Copass M. K., Martin J. S., Cobb L. A., Hallstrom A. P. Use of the automatic external defibrillator in the management of out-of-hospital cardiac arrest. N Engl J Med. 1988 Sep 15;319(11):661–666. doi: 10.1056/NEJM198809153191101. [DOI] [PubMed] [Google Scholar]

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