Abstract 22: Racial And Ethnic Differences In Bystander Cardiopulmonary Resuscitation For Witnessed Out-of-Hospital Cardiac Arrest

Abstract

Background: Racial disparities in bystander cardiopulmonary resuscitation (CPR) treatment contributes to inequities in survival for out-of-hospital cardiac arrest (OHCA). Whether bystander CPR rates differ by race/ethnicity for witnessed OHCAs in public settings is unclear but critical to understand for informing public health interventions. Methods: Within the Cardiac Arrest Registry to Enhance Survival, we identified 110,054 witnessed OHCAs during 2013-2019. Using hierarchical logistic regression, we compared rates of bystander CPR in Blacks/Hispanics vs. Whites for OHCAs at home vs. in public locations, overall and by neighborhood race and income groups. Results: Overall, 35,469 (32.2%) witnessed OHCAs occurred in Black/Hispanic individuals and 25,758 (23.4%) OHCAs occurred in public locations. Blacks/Hispanics were less likely to receive bystander CPR at home (38.5% vs. 47.4% for Whites; adjusted OR [aOR]=0.74 [95% CI: 0.71-0.76]) and in public (45.6% vs. 60.0%; aOR=0.59 [0.56-0.63]), and the magnitude of this disparity was greater for OHCAs occurring in public ( P for interaction <0.001). Lower bystander CPR rates for Blacks/Hispanics at home and in public were found in majority Black/Hispanic, Integrated, and predominantly White neighborhoods ( Table ), and the magnitude of this difference was greater for public OHCAs in each neighborhood race/ethnicity stratum (all P- values for interaction < 0.02). A similar pattern was found in high, middle, and low-income neighborhoods, with lower bystander CPR rates for Blacks/Hispanics at home and in public and a larger treatment disparity for OHCAs in public vs. at home in each income strata (all P- values for interaction < 0.001). Conclusions: Black and Hispanic victims of witnessed OHCA are less likely to receive potentially life-saving bystander CPR, as compared with White patients, and the magnitude of this disparity was greater for OHCAs witnessed in public than at home.