The relationship between race and emergency medical services resuscitation intensity for those in refractory-arrest

Background: Previous studies have reported race-based health disparities in North America. It is unknown if emergency medical service (EMS) treatment of out-of-hospital cardiac arrest (OHCA) varies based on race. We sought to compare markers of resuscitation intensity among different racial groups....

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Main Authors: Justin Yap, Jacob Hutton, Marina Del Rios, Frank Scheuermeyer, Malini Nair, Laiba Khan, Emad Awad, Takahisa Kawano, Valerie Mok, Jim Christenson, Brian Grunau
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Resuscitation Plus
Online Access:http://www.sciencedirect.com/science/article/pii/S2666520424002571
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_version_ 1846113687327211520
author Justin Yap
Jacob Hutton
Marina Del Rios
Frank Scheuermeyer
Malini Nair
Laiba Khan
Emad Awad
Takahisa Kawano
Valerie Mok
Jim Christenson
Brian Grunau
author_facet Justin Yap
Jacob Hutton
Marina Del Rios
Frank Scheuermeyer
Malini Nair
Laiba Khan
Emad Awad
Takahisa Kawano
Valerie Mok
Jim Christenson
Brian Grunau
author_sort Justin Yap
collection DOAJ
description Background: Previous studies have reported race-based health disparities in North America. It is unknown if emergency medical service (EMS) treatment of out-of-hospital cardiac arrest (OHCA) varies based on race. We sought to compare markers of resuscitation intensity among different racial groups. Methods: Using data of adult EMS-treated OHCAs from the Trial of Continuous or Interrupted Chest Compressions During CPR, we analyzed data from participants for whom on-scene return of spontaneous circulation (ROSC) was not achieved. We fit multivariate regression models using a generalized estimating equation, to estimate the association between patient race (White vs. Black vs. “Other”) and the following markers for resuscitation intensity: (1) resuscitation attempt duration; (2) intra-arrest transport; (3) number of epinephrine doses; (4) EMS arrival-to-CPR interval, and (5) 9–1–1 to first shock. Results: From our study cohort of 5370 cases, the median age was 65 years old (IQR: 53–78), 2077 (39 %) were women, 2121 (39 %) were Black, 596 (11 %) were “Other race”, 2653 (49 %) were White, and 4715 (88 %) occurred in a private location. With reference to White race, Black race was associated with a longer resuscitation attempt duration and a lower number of epinephrine doses; Black and “Other” race were both associated with a lower odds of intra-arrest transport. Conclusion: We identified race-based differences in EMS resuscitation intensity for OHCA within a North American cohort, although 40% of race data was missing from this dataset. Future research investigating race-based differences in OHCA management may be warranted.
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spelling doaj-art-f2657c37a2294d228b43ffe111c343f62024-12-21T04:29:55ZengElsevierResuscitation Plus2666-52042024-12-0120100806The relationship between race and emergency medical services resuscitation intensity for those in refractory-arrestJustin Yap0Jacob Hutton1Marina Del Rios2Frank Scheuermeyer3Malini Nair4Laiba Khan5Emad Awad6Takahisa Kawano7Valerie Mok8Jim Christenson9Brian Grunau10British Columbia Resuscitation Research Collaborative, Vancouver, British Columbia, Canada; Corresponding author at: BC Resuscitation Research Collaborative (BC RESURECT), 1190 Hornby St., 4th Floor, Vancouver, B.C. V6Z 2K5, Canada.Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Emergency Health Services, British Columbia, CanadaDepartment of Emergency Medicine, University of Iowa – Carver College of Medicine, Iowa city, IA, United StatesBritish Columbia Resuscitation Research Collaborative, Vancouver, British Columbia, Canada; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Advancing Health Outcomes, University of British Columbia, Vancouver, British Columbia, CanadaBritish Columbia Resuscitation Research Collaborative, Vancouver, British Columbia, CanadaBritish Columbia Resuscitation Research Collaborative, Vancouver, British Columbia, Canada; Faculty of Science, University of British Columbia, British Columbia, CanadaDepartment of Emergency Medicine, University of Utah, Salt Lake City, UT, United StatesBritish Columbia Resuscitation Research Collaborative, Vancouver, British Columbia, Canada; Department of Emergency Medicine, University of Fukui Hospital, Fukui Prefecture, JapanFaculty of Medicine, University of British Columbia, Vancouver, British Columbia, CanadaBritish Columbia Resuscitation Research Collaborative, Vancouver, British Columbia, Canada; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Emergency Health Services, British Columbia, CanadaBritish Columbia Resuscitation Research Collaborative, Vancouver, British Columbia, Canada; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Emergency Health Services, British Columbia, Canada; Centre for Advancing Health Outcomes, University of British Columbia, Vancouver, British Columbia, CanadaBackground: Previous studies have reported race-based health disparities in North America. It is unknown if emergency medical service (EMS) treatment of out-of-hospital cardiac arrest (OHCA) varies based on race. We sought to compare markers of resuscitation intensity among different racial groups. Methods: Using data of adult EMS-treated OHCAs from the Trial of Continuous or Interrupted Chest Compressions During CPR, we analyzed data from participants for whom on-scene return of spontaneous circulation (ROSC) was not achieved. We fit multivariate regression models using a generalized estimating equation, to estimate the association between patient race (White vs. Black vs. “Other”) and the following markers for resuscitation intensity: (1) resuscitation attempt duration; (2) intra-arrest transport; (3) number of epinephrine doses; (4) EMS arrival-to-CPR interval, and (5) 9–1–1 to first shock. Results: From our study cohort of 5370 cases, the median age was 65 years old (IQR: 53–78), 2077 (39 %) were women, 2121 (39 %) were Black, 596 (11 %) were “Other race”, 2653 (49 %) were White, and 4715 (88 %) occurred in a private location. With reference to White race, Black race was associated with a longer resuscitation attempt duration and a lower number of epinephrine doses; Black and “Other” race were both associated with a lower odds of intra-arrest transport. Conclusion: We identified race-based differences in EMS resuscitation intensity for OHCA within a North American cohort, although 40% of race data was missing from this dataset. Future research investigating race-based differences in OHCA management may be warranted.http://www.sciencedirect.com/science/article/pii/S2666520424002571
spellingShingle Justin Yap
Jacob Hutton
Marina Del Rios
Frank Scheuermeyer
Malini Nair
Laiba Khan
Emad Awad
Takahisa Kawano
Valerie Mok
Jim Christenson
Brian Grunau
The relationship between race and emergency medical services resuscitation intensity for those in refractory-arrest
Resuscitation Plus
title The relationship between race and emergency medical services resuscitation intensity for those in refractory-arrest
title_full The relationship between race and emergency medical services resuscitation intensity for those in refractory-arrest
title_fullStr The relationship between race and emergency medical services resuscitation intensity for those in refractory-arrest
title_full_unstemmed The relationship between race and emergency medical services resuscitation intensity for those in refractory-arrest
title_short The relationship between race and emergency medical services resuscitation intensity for those in refractory-arrest
title_sort relationship between race and emergency medical services resuscitation intensity for those in refractory arrest
url http://www.sciencedirect.com/science/article/pii/S2666520424002571
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