Race and ethnicity disparities in post-arrest care in Texas

Impact of Receiving Hospital on Out‐of‐Hospital Cardiac Arrest Outcome: Racial and Ethnic Disparities in Texas

“…PCI is another possible contributor to outcome disparities, as we found low rates of PCI for OHCAs from Black (2.7%) and Hispanic or Latino (4.2%) communities compared with White (9.0%) communities. 12 These rates vary considerably from reported rates of culprit coronary artery lesions that required stent placement in a clinical trial of patients without ST‐segment–elevation myocardial infarction (28.5%). 15 Last, early withdrawal of life‐sustaining therapy may be an important contributor to disparities as withdrawal of life‐sustaining therapy varies significantly and is linked to worse outcomes.…”

“…In our prior work, we found that receiving hospital plays a significant role in outcomes after OHCA, 9 corroborating findings from prior research. 10 In addition, we identified lower rates of postarrest interventions, TTM, and PCI for individuals who experience OHCA from minority 12 and lower socioeconomic status 11 neighborhoods in comparison to White and higher socioeconomic status neighborhoods. However, these associations diminished when adjusting for receiving hospital, suggesting that there are likely interhospital disparities in postarrest care.…”

“…We defined neighborhood race in a similar manner to our prior research. 6 , 12 We stratified census tract race and ethnicity into 3 categories based on census tract proportion of race and ethnicity: majority White race (>50% non‐Hispanic or Latino White), majority Black race (>50% non‐Hispanic or Latino Black), and majority Hispanic or Latino ethnicity (>50% Hispanic or Latino). As a sensitivity analysis, we additionally created >80% cohorts for race and ethnicity, if the census tract contained >80% of a race and ethnicity.…”

“… 9 , 10 We have additionally found that individuals who experience OHCA who are Black race, Hispanic or Latino ethnicity, and of lower socioeconomic status receive lower rates of hospital‐based, postarrest care modalities, primarily targeted temperature management (TTM) and percutaneous coronary intervention (PCI). 11 , 12 The best approaches to patient selection and application of both TTM 13 , 14 and PCI 15 , 16 are still actively being studied, but these therapies are associated with improved survival after OHCA. Although these therapies are certainly important aspects of hospital‐based care after cardiac arrest, there may also be other factors that contribute to outcomes, such as withdrawal of care policies and intensity of critical care strategies.…”

2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

“…1–4 Residents of predominantly Black and Hispanic neighborhoods are less likely to receive bystander CPR and less likely to survive to hospital discharge. 5–8 Female patients are less likely to receive bystander CPR and automated external defibrillator use 9,10 and to receive guideline-recommended prehospital interventions. 3,11 After cardiac arrest, female patients and people of color are less likely to receive cardiac catheterization and targeted temperature management, less likely to survive, and less likely to have good neurological recovery.…”