Introduction

Previous studies have shown racial disparities in outcomes after out-of-hospital cardiac arrest. Although several treatment factors may account for these differences, there is limited information regarding differences in CPR quality and its effect on survival in underrepresented racial populations.

Methods

We conducted a secondary analysis of data from patients enrolled in the Pragmatic Airway Resuscitation Trial (PART). We calculated compliance rates with AHA 2015 high quality CPR metrics as well as compliance to intended CPR strategy (30:2 or continuous chest compression) based on the protocol in place for the first responding EMS agency. The primary analysis used general estimating equations logistic regression to examine differences between black and white patients based on EMS-assessed race after adjustment for potential confounders. Sensitivity analyses examined differences using alternate race definitions.

Results

There were 3004 patients enrolled in PART of which 1734 had > 2 minutes of recorded CPR data and an EMS-assessed race (1003 white, 555 black, 176 other). Black patients had higher adjusted odds of compression rate compliance (OR: 1.36, 95% CI: 1.02–1.81) and lower adjusted odds of intended CPR strategy compliance (OR: 0.78, 95% CI: 0.63–0.98) compared to white patients. Of 974 transported to the hospital, there was no difference in compliance metric estimates based on ED-reported race.

Conclusion

Compression rate compliance was higher in black patients however compliance with intended strategy was lower based on EMS-assessed race. The remaining metrics showed no difference suggesting that CPR quality differences are not important contributors to the observed outcome disparities by race.

中文翻译：

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院外心脏骤停后种族与 CPR 质量的关联

介绍

先前的研究表明，院外心脏骤停后的结果存在种族差异。尽管有几个治疗因素可能导致这些差异，但关于 CPR 质量差异及其对代表性不足的种族人群生存影响的信息有限。

方法

我们对参加实用气道复苏试验 (PART) 的患者的数据进行了二次分析。我们计算了 AHA 2015 高质量 CPR 指标的依从率，以及根据第一个响应 EMS 机构的现有协议对预期 CPR 策略（30:2 或持续胸部按压）的依从性。主要分析使用一般估计方程逻辑回归来检查基于 EMS 评估种族的黑人和白人患者在调整潜在混杂因素后的差异。敏感性分析使用替代种族定义检查了差异。

结果

有 3004 名患者参加了 PART，其中 1734 名记录了超过 2 分钟的 CPR 数据和 EMS 评估的种族（1003 名白人，555 名黑人，176 名其他人）。与白人患者相比，黑人患者的按压率依从性调整几率更高（OR：1.36，95% CI：1.02-1.81），预期 CPR 策略依从性的调整几率更低（OR：0.78，95% CI：0.63-0.98）。在被送往医院的 974 人中，根据 ED 报告的种族，依从性指标估计没有差异。

结论

黑人患者的按压率依从性较高，但根据 EMS 评估的种族，对预期策略的依从性较低。其余指标显示没有差异，表明 CPR 质量差异不是观察到的种族结果差异的重要因素。