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Does race or socioeconomic status predict adverse outcome after out of hospital cardiac arrest: a multi-center study
Authors:Anthony J Sayegh  Robert Swor  Kevin H Chu  Raymond Jackson  Josh Gitlin  Robert M Domeier  Eliezer Basse  Dena Smith  William Fales
Institution:

a Department of Emergency Medicine, William Beaumont Hospital, Wayne State University School of Medicine, 3601 W. 13 Mile Rd., Royal Oak, MI 48073, USA

b Department of Emergency Medicine, Royal Brisbane Hospital, Brisbane, Australia

c St. Joseph Mercy Hospital, Ann Arbor, MI, USA

d North Oakland Medical Center, Pontiac, MI, USA

e Kalamazoo Center For Medical Studies, Kalamazoo, MI, USA

Abstract:Objective: To assess whether socioeconomic status (SES) or race is associated with adverse outcome after an out-of-hospital cardiac arrest (OHCA). Methods: A convenience sample of OHCA of presumed cardiac origin from seven suburban cities in Michigan, 1991–1996. Median household income (HHI), utilizing patient home address and 1990 census tract data, was dichotomized above and below 1990 state median income. Patient race was dichotomized as black or white. Outcome was defined as survival to hospital discharge (DC). Multiple logistic regression and Pearson’s χ2 values were used for analysis. Results: Of 1317 cases with complete data for analysis, the average age was 67.3±16.0, 939 (71.1%) were white, 587 (44.4%) arrests were witnessed (WIT), and 65 (4.9%) were DC alive. There was no significant difference between races with respect to WIT arrests, VT/VF arrest rhythms, and a small difference in EMS response interval. Whites were more likely to be above median HHI (57.1 vs. 26.2%, P<0.001). Adjusted odds ratios for predictors of survival were WIT arrest (OR=3.76, 95% CI (1.7, 8.2)), VT/VF (OR=8.74, 95% CI (3.7, 10.8), but not race (OR=0.68, 95% CI (0.3, 1.4)) or SES (OR=1.51,95% CI 0.8, 2.8). Conclusion: In this population, neither race nor SES was independently associated with a worse outcome after OHCA.
Keywords:heart arrest
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