To evaluate racial and ethnic differences in outcomes after cardiac arrest

There are disparities in cardiopulmonary resuscitation (CPR) training and rates of bystander CPR in predominantly minority communities. Studies evaluating the influence of race and ethnicity on outcomes after cardiac arrest have conflicting results.

We conducted a retrospective analysis of patients admitted to Yale-New Haven Hospital from January 2012 to December 2017 for cardiac arrest.  Statistical analysis used chi-squared tests for categorical variables and ANOVA for continuous variables.

Of the 260 patients included in this analysis, 163 (62.7%) identified as non-Hispanic Caucasian (W), 59 (22.7%) identified as non-Hispanic Black (B), and 31 (11.9%) identified as Hispanic (H). Black and Hispanic patients were younger (B:54 (17.3) and H:50 (16.1) years vs W:60 (16.6) years, P=0.006) and more likely to have end-stage renal disease (B:16.9% and H:20.7% vs. W:5.5%, P=0.011). Hispanic patients were less likely to receive bystander CPR (H:32.3% vs. W:60.6% and B:62.1%, P=0.008), despite similar rates of witnessed arrest (W:77.3%, B:77.6%, H:67.7%, P=0.356). Survival to discharge (W:25.8% vs. B:32.2% vs. H:22.6%, P=0.574) and good neurologic outcome (W:6.1% vs. B:8.5% vs. H:0%, P=0.497), defined by cerebral performance category score of 1-2, did not differ based on race or ethnicity. Although more Black patients were declared brain dead, the difference was not significant (b:18.5% vs W:6.7% vs H:6.5%, P=0.091). Withdrawal of life sustaining therapy (WLST) was less frequent in Black patients (B:40.7% vs W:66.0% and H:61.3%, P=0.017) and days to WLST was shorter in Caucasian patients (W: 4 [interquartile range 1-7] vs B:8 [5-16] and H:6 [2-16], P=0.002).

In our cohort there were no significant differences amongst racial and ethnic groups with regard to survival to discharge or good neurologic outcome after cardiac arrest. Rates and timing of WLST appear to be influenced by race and require further analysis.