背景:旁观者提供的心肺复苏(CRP)影响院外心脏骤停(OHCA)的生存率。布莱克之间旁观者复苏措施的差异,西班牙裔,亚洲人和非西班牙裔白人OHCA尚不清楚。检查旁观者复苏中的种族和种族差异对于更好的目标干预措施至关重要。
方法:在2011年4月1日至2015年6月30日之间,使用复苏结果联盟流行病学登记处3(多中心,美国和加拿大关于OHCA的对照试验。多变量logistic回归模型用于分析旁观者复苏的差异(旁观者CRP[B-CPR],心肺复苏术加上通风,自动体外除颤器/除颤器应用[B-AED/D],或电击递送)和临床结果(现场或途中死亡,首次到达急诊科[ROSC-ED]时自发循环恢复,存活直到ED放电[S-ED],存活至出院[S-HOS],和出院时良好的神经系统结果)在布莱克之间,西班牙裔,或亚裔受害者和非西班牙裔白人受害者。
结果:与非西班牙裔白人的OHCA受害者相比,黑色,西班牙裔,亚洲人接受B-CPR的可能性较小(调整后OR:0.79;95%CI:0.63-0.99),公共场所的B-AED/D(调整后的OR:0.80;95%CI:0.65-0.98)。And,黑色,西班牙裔,亚洲OHCA不太可能在街道/高速公路位置和公共建筑中接受旁观者复苏,并且不太可能有更好的临床结果,包括ROSC-ED,S-ED和S-HOS。
结论:黑色,与非西班牙裔白人受害者相比,目睹OHCA的西班牙裔和亚洲受害者不太可能接受旁观者复苏,并且更有可能获得更糟糕的结果。
BACKGROUND: Bystander-provided cardiopulmonary resuscitation (CRP) influences the survival rates of out-of-hospital cardiac arrests (OHCAs). Disparities on bystander resuscitation measures between Black, Hispanic, Asians and Non-Hispanic White OHCAs is unclear. Examining racial and ethnic differences in bystander resuscitations is essential to better target interventions.
METHODS: 15,542 witnessed OHCAs were identified between April 1, 2011, and June 30, 2015 using the Resuscitation Outcomes Consortium Epidemiologic Registry 3, a multi-center, controlled trial about OHCAs in the United States and Canada. Multivariable logistic regression model was used to analyze the differences in bystander resuscitation (bystander CRP [B-CPR], CPR plus ventilation, automated external defibrillators/defibrillator application [B-
AED/D], or delivery of shocks) and clinical outcomes (death at the scene or en route, return of spontaneous circulation upon first arrival at the emergency department [ROSC-ED], survival until ED discharge [S-ED], survival until hospital discharge [S-HOS], and favorable neurological outcome at discharge) between Black, Hispanic, or Asian victims and Non-Hispanic White victims.
RESULTS: Compared to OHCA victims in Non-Hispanic Whites, Black, Hispanic, and Asians were less likely to receive B-CPR (adjusted OR: 0.79; 95 % CI: 0.63-0.99), and B-
AED/D (adjusted OR: 0.80; 95 % CI: 0.65-0.98) in public locations. And, Black, Hispanic, and Asian OHCAs were less likely to receive bystander resuscitation in street/highway locations and public buildings, and less likely to have better clinical outcomes, including ROSC-ED, S-ED and S-HOS.
CONCLUSIONS: Black, Hispanic and Asian victims with witnessed OHCAs are less likely to receive bystander resuscitation and more likely to get worse outcomes than Non-Hispanic White victims.