Effect of race on survival following in-hospital cardiopulmonary resuscitation

Mark H. Ebell, M. Smith, J. A. Kruse, J. Drader-Wilcox, J. Novak

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Background. Race has been shown to be a significant predictive factor in a number of treatment decisions and outcomes, including survival following out- of-hospital cardiopulmonary resuscitation (CPR). The goal of this study was to determine whether race is associated with the rate of survival to discharge following in-hospital CPR. Methods. Consecutive adult patients undergoing attempted CPR at three teaching hospitals were identified. Demographic, clinical, and laboratory data from the time of admission, information about the resuscitation attempt, and the outcome of CPR were recorded for each patient. The characteristics of black and non-black patients were compared. Logistic regression was used to determine whether race was a significant independent predictor of CPR outcome. Results. A total of 656 patients were identified. Black patients had a higher mean severity of illness as measured by the Acute Physiology and Chronic Health Evaluation (APACHE) III score, were more likely to have an initial rhythm of electromechanical dissociation or asystole, were less likely to have an admitting diagnosis of myocardial infarction or a history of coronary artery disease, and had a higher serum creatinine level, lower serum albumin value, and lower 24-hour urine output for the first 24 hours. There was no difference between black and nonblack patients regarding the rate of survival of the resuscitative effort itself. However, black patients were significantly less likely than nonblack patients to survive to discharge following resuscitation (Mantel-Haenszel odds ratio, 0.31; 95% confidence interval, 0.15 to 0.68). This relationship persisted after adjusting for potential confounders such as age, sex, initial cardiac rhythm, diagnosis of pneumonia, serum creatinine level, hospital, and APACHE III score. Conclusions. Black race is significantly associated with a lower rate of survival to discharge following in-hospital CPR. Further work is needed to explore this association in other settings; to examine the effect of other possible confounding variables, such as tobacco use, socioeconomic status, and marital status; and to further study the determinants of physician decision-making about resuscitation.

Original languageEnglish (US)
Pages (from-to)571-577
Number of pages7
JournalJournal of Family Practice
Volume40
Issue number6
StatePublished - Jan 1 1995

Fingerprint

Cardiopulmonary Resuscitation
Survival
Resuscitation
APACHE
Survival Rate
Creatinine
Confounding Factors (Epidemiology)
Marital Status
Tobacco Use
Heart Arrest
Serum
Social Class
Serum Albumin
Teaching Hospitals
Coronary Artery Disease
Pneumonia
Decision Making
Logistic Models
Odds Ratio
Myocardial Infarction

Keywords

  • Race
  • cardiopulmonary resuscitation
  • resuscitation
  • survival

ASJC Scopus subject areas

  • Family Practice

Cite this

Ebell, M. H., Smith, M., Kruse, J. A., Drader-Wilcox, J., & Novak, J. (1995). Effect of race on survival following in-hospital cardiopulmonary resuscitation. Journal of Family Practice, 40(6), 571-577.

Effect of race on survival following in-hospital cardiopulmonary resuscitation. / Ebell, Mark H.; Smith, M.; Kruse, J. A.; Drader-Wilcox, J.; Novak, J.

In: Journal of Family Practice, Vol. 40, No. 6, 01.01.1995, p. 571-577.

Research output: Contribution to journalArticle

Ebell, MH, Smith, M, Kruse, JA, Drader-Wilcox, J & Novak, J 1995, 'Effect of race on survival following in-hospital cardiopulmonary resuscitation', Journal of Family Practice, vol. 40, no. 6, pp. 571-577.
Ebell MH, Smith M, Kruse JA, Drader-Wilcox J, Novak J. Effect of race on survival following in-hospital cardiopulmonary resuscitation. Journal of Family Practice. 1995 Jan 1;40(6):571-577.
Ebell, Mark H. ; Smith, M. ; Kruse, J. A. ; Drader-Wilcox, J. ; Novak, J. / Effect of race on survival following in-hospital cardiopulmonary resuscitation. In: Journal of Family Practice. 1995 ; Vol. 40, No. 6. pp. 571-577.
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