Journal article
The Role of Hospital Performance on Race and Ethnicity Outcome Disparities for US Non-Traumatic Out-of-Hospital Cardiac Arrests
Resuscitation, Vol.208, 110496
03/2025
DOI: 10.1016/j.resuscitation.2025.110496
PMID: 39826865
Abstract
Factors contributing to worse outcomes for out-of-hospital cardiac arrests (OHCA) from minoritized communities are poorly understood. We sought to evaluate the impact of receiving hospital performance on OHCA outcome disparities.
We performed a retrospective cohort study of non-traumatic OHCAs from the National Cardiac Arrest Registry to Enhance Survival from 2013-2022 that survived hospital admission. We created cohorts based on census-tract race/ethnicity: >50% White, >50% Black, and >50% Hispanic/Latino. We stratified hospitals into performance quartiles based on hospital good neurologic outcome rates. We evaluated the association between race/ethnicity and care at better-performing hospitals. Using hierarchical modeling, we compared models evaluating the association between community race/ethnicity and outcomes, ignoring and adjusting for receiving hospital.
We included 202,117 OHCAs. Compared to White, OHCAs from Black (OR 0.12[0.12-0.13]) and Hispanic/Latino (OR 0.21[0.20-0.21]) communities had lower odds of care at higher-performing hospitals, but care at higher-performing hospitals improved outcomes for all groups: White – OR 1.43[1.41-1.44]), Black – OR 1.54[1.50-1.59]), Hispanic/Latino - 1.51[1.46-1.56]. Ignoring receiving hospital, outcomes were worse for OHCAs from Black (aOR 0.56[0.54-0.58]) and Hispanic/Latino (aOR 0.63[0.61-0.66]) communities. Although adjusting for bystander cardiopulmonary resuscitation did not change results, adjusting for hospital performance quartile improved outcome odds (Black – aOR 0.80[0.76-0.84]; Hispanic/Latino – aOR 0.82[0.78-0.86]). Adjusting for receiving hospital random effect also improved outcome odds (Black – aOR 0.84[0.81-0.87]; Hispanic Latino – aOR 0.86[0.83-0.90]).
OHCAs from Black and Hispanic/Latino communities received care at high-performing hospitals less often, and adjusting for receiving hospital significantly diminished OHCA outcome disparities.
Details
- Title: Subtitle
- The Role of Hospital Performance on Race and Ethnicity Outcome Disparities for US Non-Traumatic Out-of-Hospital Cardiac Arrests
- Creators
- Ryan Huebinger - University of New MexicoMarina Del Rios - Texas Emergency Medicine Research Center, McGovern Medical School, Houston, TXBenjamin S. Abella - University of PennsylvaniaBryan McNally - Emory UniversityCarrie Bakunas - The University of Texas Health Science Center at HoustonRichard Witkov - The University of Texas Health Science Center at HoustonJoseph Gill - The University of Texas Health Science Center at HoustonBentley Bobrow - University of IowaCARES Surveillance Group
- Resource Type
- Journal article
- Publication Details
- Resuscitation, Vol.208, 110496
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.resuscitation.2025.110496
- PMID
- 39826865
- ISSN
- 0300-9572
- eISSN
- 1873-1570
- Language
- English
- Electronic publication date
- 01/16/2025
- Date published
- 03/2025
- Academic Unit
- Emergency Medicine
- Record Identifier
- 9984775260602771
Metrics
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