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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...

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Autores principales: Moeller, Sidsel, Hansen, Carolina M., Kragholm, Kristian, Dupre, Matt E., Sasson, Comilla, Pearson, David A., Tyson, Clark, Jollis, James G., Monk, Lisa, Starks, Monique A., McNally, Bryan, Thomas, Kevin L., Becker, Lance, Torp‐Pedersen, Christian, Granger, Christopher B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649293/
https://www.ncbi.nlm.nih.gov/pubmed/34431375
http://dx.doi.org/10.1161/JAHA.120.019082
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author Moeller, Sidsel
Hansen, Carolina M.
Kragholm, Kristian
Dupre, Matt E.
Sasson, Comilla
Pearson, David A.
Tyson, Clark
Jollis, James G.
Monk, Lisa
Starks, Monique A.
McNally, Bryan
Thomas, Kevin L.
Becker, Lance
Torp‐Pedersen, Christian
Granger, Christopher B.
author_facet Moeller, Sidsel
Hansen, Carolina M.
Kragholm, Kristian
Dupre, Matt E.
Sasson, Comilla
Pearson, David A.
Tyson, Clark
Jollis, James G.
Monk, Lisa
Starks, Monique A.
McNally, Bryan
Thomas, Kevin L.
Becker, Lance
Torp‐Pedersen, Christian
Granger, Christopher B.
author_sort Moeller, Sidsel
collection PubMed
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.
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spelling pubmed-86492932022-01-14 Race Differences in Interventions and Survival After Out‐of‐Hospital Cardiac Arrest in North Carolina, 2010 to 2014 Moeller, Sidsel Hansen, Carolina M. Kragholm, Kristian Dupre, Matt E. Sasson, Comilla Pearson, David A. Tyson, Clark Jollis, James G. Monk, Lisa Starks, Monique A. McNally, Bryan Thomas, Kevin L. Becker, Lance Torp‐Pedersen, Christian Granger, Christopher B. J Am Heart Assoc JAHA Spotlight on Racial and Ethnic Disparities in Cardiovascular Medicine 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. John Wiley and Sons Inc. 2021-08-25 /pmc/articles/PMC8649293/ /pubmed/34431375 http://dx.doi.org/10.1161/JAHA.120.019082 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle JAHA Spotlight on Racial and Ethnic Disparities in Cardiovascular Medicine
Moeller, Sidsel
Hansen, Carolina M.
Kragholm, Kristian
Dupre, Matt E.
Sasson, Comilla
Pearson, David A.
Tyson, Clark
Jollis, James G.
Monk, Lisa
Starks, Monique A.
McNally, Bryan
Thomas, Kevin L.
Becker, Lance
Torp‐Pedersen, Christian
Granger, Christopher B.
Race Differences in Interventions and Survival After Out‐of‐Hospital Cardiac Arrest in North Carolina, 2010 to 2014
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 JAHA Spotlight on Racial and Ethnic Disparities in Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649293/
https://www.ncbi.nlm.nih.gov/pubmed/34431375
http://dx.doi.org/10.1161/JAHA.120.019082
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