The association of race with CPR quality following out-of-hospital cardiac arrest

Robert H. Schmicker, Audrey Blewer, Joshua R. Lupton, Tom P. Aufderheide, Henry E. Wang, Ahamed H. Idris, Elisabete Aramendi, Mohamed B. Hagahmed, Owen T. Traynor, M. Riccardo Colella, Mohamud R. Daya

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Previous studies have shown racial disparities in outcomes after out-of-hospital cardiac arrest. Although several treatment factors may account for these differences, there is limited information regarding differences in CPR quality and its effect on survival in underrepresented racial populations. Methods: We conducted a secondary analysis of data from patients enrolled in the Pragmatic Airway Resuscitation Trial (PART). We calculated compliance rates with AHA 2015 high quality CPR metrics as well as compliance to intended CPR strategy (30:2 or continuous chest compression) based on the protocol in place for the first responding EMS agency. The primary analysis used general estimating equations logistic regression to examine differences between black and white patients based on EMS-assessed race after adjustment for potential confounders. Sensitivity analyses examined differences using alternate race definitions. Results: There were 3004 patients enrolled in PART of which 1734 had > 2 minutes of recorded CPR data and an EMS-assessed race (1003 white, 555 black, 176 other). Black patients had higher adjusted odds of compression rate compliance (OR: 1.36, 95% CI: 1.02–1.81) and lower adjusted odds of intended CPR strategy compliance (OR: 0.78, 95% CI: 0.63–0.98) compared to white patients. Of 974 transported to the hospital, there was no difference in compliance metric estimates based on ED-reported race. Conclusion: Compression rate compliance was higher in black patients however compliance with intended strategy was lower based on EMS-assessed race. The remaining metrics showed no difference suggesting that CPR quality differences are not important contributors to the observed outcome disparities by race.

Original languageEnglish (US)
Pages (from-to)194-200
Number of pages7
JournalResuscitation
Volume170
DOIs
StatePublished - Jan 2022
Externally publishedYes

Keywords

  • Chest compressions
  • Emergency medicine
  • Racial disparities

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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