Abstract 117: A Population Based Study in a Large Ethnically Diverse Metropolitan City Reveals Racial and Ethnic Disparities in Pediatric Cardiac Arrest

Abstract

Background: Data regarding racial and ethnic differences in incidence and survival in pediatric cardiac arrest are unknown. In large cities, universal tracking of cardiac arrest is limited by multiple response centers fielding calls. This study was performed in Houston, one of the largest and most ethnically diverse cities in the US. Every 911 call in the city is tracked by a single operations center, providing a unique opportunity to conduct a population based study. Objective: We aimed to examine race and ethnic differences in incidence and survival rates among pediatric cardiac arrests utilizing a non-sampled population in a large metropolitan area. Methods: We performed a retrospective review of all 911 emergency response records involving non-traumatic pediatric cardiac arrests <18 years between 2002-2017. Race and ethnicity data among patients with cardiac arrests were compared to Houston population census data. Results: There were 598 (57% males) pediatric cardiac arrests at median age of 10 mo (IQR 2 mo - 6 yrs). Infants <2 yrs accounted for 60% of cases, 2-5 yrs (14%), 6-10 yrs (15%) and 11-17 yrs (11%). Overall, non-Hispanic black children comprised a significantly larger proportion of those with cardiac arrest than would be expected given population distribution (Figure). When evaluating these differences by age, the largest discrepancy was among infants, where odds of arrest in non-Hispanic black or Hispanic was 2.3 (95%CI 1.2-4.4) and 2.9 (95% CI 1.4-5.8) compared to white children. Overall survival was poor (9%) and did not differ by race/ethnicity, sex, bystander CPR, or time from 911 call to emergency personnel arrival. The only variable associated with greater survival was witnessed arrest (OR 2.2, 95%CI 1.2-4.0). Conclusions: There are racial differences in cardiac arrest in Houston based on age. Identifying reasons for these differences may provide insights into environmental or genetic risk factors associated with pediatric cardiac arrests.