Comparison of Out-of-Hospital Cardiac Arrest Outcomes Between Asian and White Individuals in the United States

• Published in: Journal of the American Heart Association Vol. 12; no. 18; p. e030087
• Main Authors: Gupta, Kashvi, Raj, Rohan, Asaki, S Yukiko, Kennedy, Kevin, Chan, Paul S
• Format: Journal Article
• Language: English
• Published: England John Wiley and Sons Inc 19.09.2023; Wiley
• Subjects: Asian; bystander cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - methods; Emergency Medical Services; Humans; Original Research; out of hospital cardiac arrest; Out-of-Hospital Cardiac Arrest - diagnosis; Out-of-Hospital Cardiac Arrest - etiology; Out-of-Hospital Cardiac Arrest - therapy; Registries; survival; United States - epidemiology; White; United States; Asian; out of hospital cardiac arrest; bystander cardiopulmonary resuscitation; survival
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.123.030087

Background Disparities in bystander cardiopulmonary resuscitation (CPR) and survival have been reported for Black and Hispanic individuals with out-of-hospital cardiac arrest (OHCA). Whether Asian individuals have lower rates of bystander CPR and survival for OHCA, as compared with White individuals, remains unknown. Methods and Results Within the US-based CARES (Cardiac Arrest Registry to Enhance Survival), we identified 278 989 OHCAs in Asian and White individuals during 2013 to 2021. Using hierarchical Poisson logistic regression with emergency medical service agency modeled as a random effect and patient and OHCA characteristics as fixed effects, we compared rates of bystander CPR, survival to discharge, and favorable neurological survival between Asian and White individuals with OHCA. Overall, 14 835 (5.3%) OHCAs occurred in Asian individuals. Compared with White individuals with OHCA, Asian individuals were older (67.0±17.6 versus 62.8±16.9 years) and were less likely to have drug overdose as the cause of OHCA (1.3% versus 6.6%) and a shockable arrest rhythm (19.2% versus 22.4%). Layperson bystander CPR rates were similar between Asian and White individuals (42.6% versus 42.1%; adjusted relative risk for Asian individuals, 0.99 [95% CI, 0.97-1.02]; =0.69). However, rates of survival to discharge were lower in Asian individuals with OHCA (8.2% versus 10.3%; adjusted relative risk 0.92 [0.86-0.98] =0.006). Similarly, the rate of favorable neurological survival was lower for Asian individuals (6.5% versus 8.7%; adjusted relative risk, 0.85 [0.79-0.91]; <0.001). Conclusions Despite similar rates of bystander CPR, Asian individuals with OHCA have lower survival rates than White individuals with OHCA. The reasons for the lower survival rate deserve further study to determine whether there are disparities in resuscitation care between Asian and White individuals with OHCA.