Background Differences between blacks and whites have been reportedin the incidence of several forms of cardiovascular disease,including hypertension and stroke. We examined racial differencesin the incidence of cardiac arrest in a large urban populationand in subsequent survival.
Methods We collected data on all nontraumatic, out-of-hospitalcardiac arrests in Chicago from January 1, 1987, through December31, 1988, and compared the incidence and survival rates forblacks and whites. We examined the association between survivaland race and seven other known risk factors by logistic-regressionanalysis. We computed incidence rates by coupling our data withU.S. Census population data.
Results Our study population comprised 6451 patients: 3207 whites,2910 blacks, and 334 persons of other races. The incidence ofcardiac arrest was significantly higher for blacks than forwhites in every age group. The survival rate after cardiac arrestwas 2.6 percent in whites, as compared with 0.8 percent in blacks(P<0.001). Blacks were significantly less likely to havea witnessed cardiac arrest, bystander-initiated cardiopulmonaryresuscitation, or a "favorable" initial rhythm or to be admittedto the hospital. When they were admitted, blacks were half aslikely to survive. The association between race and survivalpersisted even when other recognized risk factors were takeninto account. We did not find important differences betweenblacks and whites in the response times of the emergency medicalservices.
Conclusions The black community in our study was at higher riskfor cardiac arrest and subsequent death than the white community,even after we controlled for other variables.
Source Information
From the Section of Emergency Medicine, Department of Medicine (L.B.B., B.H.H.), and the Department of Statistics (F.A.W.), University of Chicago, Chicago; the Department of Preventive Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago (P.M.M.); the Emergency Department, Resurrection Hospital, Chicago (K.V.R.); the Department of Epidemiology and Statistics, University of Oklahoma, Oklahoma City (D.W.S.); and the Bureau of Emergency Medical Services, Chicago Fire Department, Chicago (J.B.).
Address reprint requests to Dr. Becker at MC 5068, 5841 S. Maryland Ave., University of Chicago Hospitals, Chicago, IL 60637.
Heart Disease and Race
Lai S., Page J. B., Rodney E., Vasavada B. C., Sacchi T. J., Platt F. W., Becker L. B., Meyer P. M., Whittle J., Conigliaro J., Good C.B.
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N Engl J Med 1994;
330:216-218, Jan 20, 1994.
Correspondence
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