Acute cardiac care & resuscitationCohort study
Pediatric out-of-hospital cardiac arrest outcomes by Child Opportunity Index, race and ethnicity
- retrospective cohort study
- logistic regression
- mediation analysis
Authors' conclusion
Arrests occurring in lower COI areas and among Black/African American children are associated with lower odds of a favorable outcome. Lower bystander response partially explains these associations.
Study context
- Population
- Children ≤18 years with OHCA in the Cardiac Arrest Registry to Enhance Survival (CARES)
- Participants
- 17,903 children
- Exposure
- Child Opportunity Index (COI) quintiles and race and ethnicity and pediatric OHCA outcomes, with bystander response as a mediator
- Outcome
- survival to hospital discharge with favorable neurological outcome (Pediatric Cerebral Performance Category ≤2)
- Follow-up
- Hospital discharge
Main finding
As reported in the abstract
Adjusted odds ratio (95% CI)P value
very low COI vs very high COI
0.68(0.54–0.84)
P < 0.001Black/African American vs White
0.81(0.69–0.96)
P = 0.02- Overall favorable outcome
- 1654/17,903 (9.2%)
Observational data: associations, not effects.
Further findings
Arrest characteristics
- Arrests in lower COI neighborhoods and in Black/African American children occurred more frequently in infants and were less likely to be witnessed and to receive bystander response
Mediation by bystander response
- adjusted percent mediated, lower COI quintiles
- 11.7% [95% CI 5.5-17.9], P < 0.001
- adjusted percent mediated, Black/African American race
- 15.6% [95% CI 7.5-23.6], P < 0.001
- partially mediated
Original publication
Pediatric out-of-hospital cardiac arrest outcomes by Child Opportunity Index, race and ethnicity. Resuscitation. Published 16 January 2026. doi:10.1016/j.resuscitation.2026.110970
Summarised from the published abstract; every number is checked against it