Race Differences in Interventions and Survival After Out‐of‐Hospital Cardiac Arrest in North Carolina, 2010 to 2014
Background Following the implementation of the HeartRescue project, with interventions in the community, emergency medical services, and hospitals to improve care and outcomes for out‐of‐hospital cardiac arrests (OHCA) in North Carolina, improved bystander and first responder treatments as well as s...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-09-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.019082 |
| _version_ | 1818727651173466112 |
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| author | Sidsel Moeller Carolina M. Hansen Kristian Kragholm Matt E. Dupre Comilla Sasson David A. Pearson Clark Tyson James G. Jollis Lisa Monk Monique A. Starks Bryan McNally Kevin L. Thomas Lance Becker Christian Torp‐Pedersen Christopher B. Granger |
| author_facet | Sidsel Moeller Carolina M. Hansen Kristian Kragholm Matt E. Dupre Comilla Sasson David A. Pearson Clark Tyson James G. Jollis Lisa Monk Monique A. Starks Bryan McNally Kevin L. Thomas Lance Becker Christian Torp‐Pedersen Christopher B. Granger |
| author_sort | Sidsel Moeller |
| collection | DOAJ |
| description | Background Following the implementation of the HeartRescue project, with interventions in the community, emergency medical services, and hospitals to improve care and outcomes for out‐of‐hospital cardiac arrests (OHCA) in North Carolina, improved bystander and first responder treatments as well as survival were observed. This study aimed to determine whether these improvements were consistent across Black versus White individuals. Methods and Results Using the Cardiac Arrest Registry to Enhance Survival (CARES), we identified OHCA from 16 counties in North Carolina (population 3 million) from 2010 to 2014. Temporal changes in interventions and outcomes were assessed using multilevel multivariable logistic regression, adjusted for patient and socioeconomic neighborhood‐level factors. Of 7091 patients with OHCA, 36.5% were Black and 63.5% were White. Black patients were younger, more females, had more unwitnessed arrests and non‐shockable rhythm (Black: 81.0%; White: 75.4%). From 2010 to 2014, the adjusted probabilities of bystander cardiopulmonary resuscitation (CPR) went from 38.5% to 51.2% in White, P<0.001; and 36.9% to 45.6% in Black, P=0.002, and first‐responder defibrillation went from 13.2% to 17.2% in White, P=0.002; and 14.7% to 17.3% in Black, P=0.16. From 2010 to 2014, survival to discharge only increased in White (8.0% to 11.4%, P=0.004; Black 8.9% to 9.5%, P=0.60), though, in shockable patients the probability of survival to discharge went from 24.8% to 34.6% in White, P=0.02; and 21.7% to 29.0% in Black, P=0. 10. Conclusions After the HeartRescue program, bystander CPR and first‐responder defibrillation increased in both patient groups; however, survival only increased significantly for White patients. |
| first_indexed | 2024-12-17T22:17:29Z |
| format | Article |
| id | doaj.art-ff3942c1811349fabe205d3ae4834f2e |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-17T22:17:29Z |
| publishDate | 2021-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-ff3942c1811349fabe205d3ae4834f2e2022-12-21T21:30:34ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-09-01101710.1161/JAHA.120.019082Race Differences in Interventions and Survival After Out‐of‐Hospital Cardiac Arrest in North Carolina, 2010 to 2014Sidsel Moeller0Carolina M. Hansen1Kristian Kragholm2Matt E. Dupre3Comilla Sasson4David A. Pearson5Clark Tyson6James G. Jollis7Lisa Monk8Monique A. Starks9Bryan McNally10Kevin L. Thomas11Lance Becker12Christian Torp‐Pedersen13Christopher B. Granger14Duke Clinical Research Institute Durham NCDuke Clinical Research Institute Durham NCDuke Clinical Research Institute Durham NCDuke Clinical Research Institute Durham NCDepartment of Emergency Medicine University of Colorado School of Medicine Aurora COCarolinas Medical Center Charlotte Charlotte NCDuke Clinical Research Institute Durham NCDuke Clinical Research Institute Durham NCDuke Clinical Research Institute Durham NCDuke Clinical Research Institute Durham NCEmory University School of Medicine Atlanta Atlanta GADuke Clinical Research Institute Durham NCDepartment of Emergency Medicine Northwell HealthHofstra Northwell School of Medicine at Hofstra University Manhasset NYDepartment of Cardiology Nordsjaellands Hospital Hillerød DenmarkDuke Clinical Research Institute Durham NCBackground Following the implementation of the HeartRescue project, with interventions in the community, emergency medical services, and hospitals to improve care and outcomes for out‐of‐hospital cardiac arrests (OHCA) in North Carolina, improved bystander and first responder treatments as well as survival were observed. This study aimed to determine whether these improvements were consistent across Black versus White individuals. Methods and Results Using the Cardiac Arrest Registry to Enhance Survival (CARES), we identified OHCA from 16 counties in North Carolina (population 3 million) from 2010 to 2014. Temporal changes in interventions and outcomes were assessed using multilevel multivariable logistic regression, adjusted for patient and socioeconomic neighborhood‐level factors. Of 7091 patients with OHCA, 36.5% were Black and 63.5% were White. Black patients were younger, more females, had more unwitnessed arrests and non‐shockable rhythm (Black: 81.0%; White: 75.4%). From 2010 to 2014, the adjusted probabilities of bystander cardiopulmonary resuscitation (CPR) went from 38.5% to 51.2% in White, P<0.001; and 36.9% to 45.6% in Black, P=0.002, and first‐responder defibrillation went from 13.2% to 17.2% in White, P=0.002; and 14.7% to 17.3% in Black, P=0.16. From 2010 to 2014, survival to discharge only increased in White (8.0% to 11.4%, P=0.004; Black 8.9% to 9.5%, P=0.60), though, in shockable patients the probability of survival to discharge went from 24.8% to 34.6% in White, P=0.02; and 21.7% to 29.0% in Black, P=0. 10. Conclusions After the HeartRescue program, bystander CPR and first‐responder defibrillation increased in both patient groups; however, survival only increased significantly for White patients.https://www.ahajournals.org/doi/10.1161/JAHA.120.019082interventionOHCAracesurvival |
| spellingShingle | Sidsel Moeller Carolina M. Hansen Kristian Kragholm Matt E. Dupre Comilla Sasson David A. Pearson Clark Tyson James G. Jollis Lisa Monk Monique A. Starks Bryan McNally Kevin L. Thomas Lance Becker Christian Torp‐Pedersen Christopher B. Granger Race Differences in Interventions and Survival After Out‐of‐Hospital Cardiac Arrest in North Carolina, 2010 to 2014 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease intervention OHCA race survival |
| title | Race Differences in Interventions and Survival After Out‐of‐Hospital Cardiac Arrest in North Carolina, 2010 to 2014 |
| title_full | Race Differences in Interventions and Survival After Out‐of‐Hospital Cardiac Arrest in North Carolina, 2010 to 2014 |
| title_fullStr | Race Differences in Interventions and Survival After Out‐of‐Hospital Cardiac Arrest in North Carolina, 2010 to 2014 |
| title_full_unstemmed | Race Differences in Interventions and Survival After Out‐of‐Hospital Cardiac Arrest in North Carolina, 2010 to 2014 |
| title_short | Race Differences in Interventions and Survival After Out‐of‐Hospital Cardiac Arrest in North Carolina, 2010 to 2014 |
| title_sort | race differences in interventions and survival after out of hospital cardiac arrest in north carolina 2010 to 2014 |
| topic | intervention OHCA race survival |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.019082 |
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