Acute cardiac care & resuscitation
Factors mediating community race and ethnicity differences in initial shockable rhythm for out-of-hospital cardiac arrests in Texas
Authors' conclusion
Bystander-witnessed OHCA and public location were the largest mediators of shockable rhythm for OHCAs from minoritized communities.
Study context
- Population
- Out-of-hospital Cardiac Arrest (OHCAs) in the Texas Cardiac Arrest Registry to Enhance Survival (TX-CARES), 2013–2022
- Participants
- 22,730 / 4,749 / 16,054
- Exposure
- Majority Black and majority Hispanic/Latino communities vs majority White communities
- Majority Whiten = 22,730reference
- Majority Blackn = 4,749
- Majority Hispanic/Latinon = 16,054
Methodological detailsregistry-based, mediation analysis (structural equation modeling)
- Registry-based
- Mediation analysis (structural equation modeling)
Main finding
As reported in the abstract
Initial shockable rhythm
- Top mediators of initial shockable rhythm, majority Black: public location
- 14.6%
- Top mediators, majority Black: bystander-witnessed OHCA
- 11.6%
- Top mediators, majority Black: female gender
- 5.7%
- Top mediators, majority Hispanic/Latino: bystander-witnessed OHCA
- 10.2%
- Top mediators, majority Hispanic/Latino: public location
- 3.52%
- Top mediators, majority Hispanic/Latino: bystander CPR
- 3.49%
Observational data: associations, not effects.
Further findings
Favorable neurologic outcome, unadjusted (odds vs majority White)
- Majority Black: lower odds
- 0.4 [0.3-0.5]
- Majority Hispanic/Latino: lower odds
- 0.6 [0.6-0.7]
Favorable neurologic outcome, adjusted for shockable rhythm (odds vs majority White)
- Black communities: odds increased after adjusting for shockable rhythm
- 0.5 [0.4-0.5]
- Hispanic/Latino communities: odds increased after adjusting for shockable rhythm
- 0.7 [0.6-0.8]
- Adjusting for bystander CPR (bCPR) minimally changed outcome odds
Mediators of initial shockable rhythm, majority Black communities
- Public location
- 14.6%
- Bystander-witnessed OHCA
- 11.6%
- Female gender
- 5.7%
- Mediation analysis (structural equation modeling)
Mediators of initial shockable rhythm, majority Hispanic/Latino communities
- Bystander-witnessed OHCA
- 10.2%
- Public location
- 3.52%
- Bystander CPR
- 3.49%
- Mediation analysis (structural equation modeling)
Original publication
Factors mediating community race and ethnicity differences in initial shockable rhythm for out-of-hospital cardiac arrests in Texas. Resuscitation. Published 10 May 2024. doi:10.
Summarised from the published abstract; every number is checked against it