Do blacks get bystander cardiopulmonary resuscitation as often as whites?

Abstract

Study objective: To determine whether there is an association between the race of a victim of out-of-hospital cardiac arrest and the provision of bystander-initiated CPR.

Design: Record review of 1,068 consecutive cases of nontraumatic out-of-hospital cardiac arrest.

Setting: Memphis, Tennessee, a city of more than 600,000 with roughly equal numbers of white and black residents.

Participants: Every adult who was seen by municipal emergency medical services personnel for nontraumatic cardiac arrest between March 1, 1989, and June 5, 1992.

Intervention: None.

Results: Although black and white cardiac arrest victims were similar in many respects, black victims received bystander CPR substantially less frequently than whites (9.8% versus 21.4%; odds ratio, 0.46; 95% confidence interval, 0.34 to 0.61). This difference was slightly more pronounced when the victim collapsed in a public place. In addition to race of the victim, location of the arrest outside the home and having the arrest witnessed were independent determinants of whether a victim was given bystander CPR. Multiple logistic regression analysis showed that the effect of race was independent of the other variables studied.

Conclusion: Black victims of out-of-hospital cardiac arrest receive bystander CPR less frequently than white victims. Targeted training programs may be needed to improve the rates of bystander CPR among certain groups.