Abstract 2641: Racial Disparities in Manifestation and Outcome of Sudden Cardiac Arrest
Introduction: It has been suggested that race is likely to influence sudden cardiac arrest (SCA) but systematic studies are lacking. We therefore performed a prospective, multiple-source, population based study to evaluate the effects of race on SCA.
Methods: SCA cases age ≥ 18 yrs were ascertained from an ongoing evaluation of approx 1 million residents of a large metropolitan area in the northwestern US. The relationship between race and pre-specified variables related to SCA was evaluated among cases that underwent attempted resuscitation by EMS personnel. We used Pearson chi-square tests for categorical variables and analysis of covariance with Tukey-Kramer post-hoc tests to determine significant differences among groups.
Results: A total of 1277 cases met criteria (mean age 65±15 yrs; 67% were male; White 86.4%, Black/AA 7.3%, Hispanic 2.1%, Asian 2.9% and other 1.3%). Presenting rhythm at the time of arrest was ventricular fibrillation or tachycardia (VF/VT) in 48% of cases, and pulseless electrical activity (PEA) or asystole in 26% each. There was no significant difference in the proportion of cases with attempted resuscitation across race categories (p=0.88). Among resuscitated cases, Whites were more likely to have VF/VT, while Blacks more likely presented with PEA and Asian cases with asystole (p=0.004) (table⇓). These findings were not explained by differences in response time (p=0.23). Black and Hispanic cases suffered SCA at a significantly younger age than White and Asian cases (p<0.0001). There were no significant race differences in any of the other arrest circumstances or outcomes: return of spontaneous circulation, survival to hospital discharge, or witnessed arrests (p≥0.11).
Conclusions: Different races had equal opportunity for resuscitation as well as survival. However, there were significant differences in manifestation of SCA, indicating an area of potentially high yield for investigative approaches to SCA prevention.