Racial differences in cardiac arrest survival: insights from Minnesota metro data and the University of Minnesota extracorporeal cardiopulmonary resuscitation cohort.

AIMS: The study explores the association between race, survival and neurological outcomes among out-of-hospital cardiac arrest (OHCA) patients listed in Minnesota metro and the University of Minnesota Extracorporeal Cardiopulmonary Resuscitation (UMN-ECPR) program.

METHODS

This retrospective study included OHCA patients with initial shockable rhythm from two distinct cohorts: the Minnesota metro CARES cohort, treated with conventional CPR and the UMN-ECPR database (2016-2023). Race was categorized as white or non-white. Good neurological outcome was defined as a Cerebral-Performance-Category score of 1-2. Logistic regression analyses examined survival by race, with primary models adjusted for age and gender and exploratory models further adjusted for witnessed status, location, bystander CPR, return-of-spontaneous-circulation, CPR duration.

RESULTS

Of 2,700 OHCA patients in the CARES cohort, primarily treated with conventional CPR, 16.5 % were non-white. Compared to white patients, non-whites were younger (mean age 54.0 vs. 64.4 years), more often female (32.8 % vs. 23.6 %), and less likely to receive bystander CPR (52.2 % vs. 60 %). Non-white patients had lower age- and gender-adjusted odds of survival to discharge (OR: 0.64; 95 % CI, 0.5-0.82; p < 0.001) and favorable neurological outcome (OR: 0.48; 95 % CI, 0.35-0.64; p < 0.001). Among 414 ECPR patients (22.7 % non-white), non-white patients were younger (mean age 51 vs. 58.8 years) with lower bystander CPR rates (65.2 % vs. 74.8 %). There were no significant differences in age- and gender-adjusted survival (OR: 1.17; 95 % CI, 0.69-2; p = 0.554) or neurological outcome (OR: 1.07; 95 % CI, 0.61-1.88; p = 0.818).

CONCLUSION

Non-white race was linked to worse outcomes in the conventional CPR cohort but not in the ECPR cohort.