Blacks less likely to survive CPR in the hospital
Black patients are less likely to survive efforts to revive them after their hearts suddenly stop beating in the hospital than are whites, a new study said..
Black patients are less likely to survive efforts to revive them after their hearts suddenly stop beating in the hospital than are whites, a new study out in the Journal of the American Medical Association shows.
And much-but not all--of the difference is due to the fact that black patients were more likely to receive care at poorly performing hospitals, Dr. Paul S. Chan of St. Luke's Mid America Heart Institute in Kansas City, Missouri and his colleagues found.
Research into the well-known disparities in health between blacks and whites has been extensive. But studying cardiac arrest - in which the heart stops beating suddenly, after which it can sometimes be restarted successfully using cardiopulmonary resuscitation (CPR) -- is a "unique opportunity" to examine disparities in a context where access to care is not a factor.
That's because patients are already in the hospital, and "there is little debate regarding clinical appropriateness of treatment in eligible patients," write Chan and his colleagues.
The researchers looked at 10,011 patients who had suffered cardiac arrest at 274 different hospitals. Among the black patients, who represented 18.8% of study participants, 25.2% survived until being discharged from the hospital, compared to 37.4% of white patients.
Among black patients, 55.8% were successfully resuscitated, compared to 67.4% of whites; 45.2% of black patients survived after being resuscitated, compared to 55.5% of whites.
The black patients were sicker, for example having higher rates of diabetes, stroke, and major trauma. This accounted for some of the difference in survival between blacks and whites.
But the strongest factor accounting for the disparity was the fact that black patients were more likely to have been cared for at hospitals with worse outcomes. Differences in hospital performance accounted for a large proportion of the racial disparities in resuscitation success, and all of the differences in survival after resuscitation.
More research is needed to explain why resuscitation after cardiac arrest was less successful in black patients than in whites, the researchers say; potential factors could include differences in the way chest compressions and ventilation are delivered, medications used, or "clinician and/or institutional bias."
Reuters Güncelleme Tarihi: 16 Eylül 2009, 14:02