Survival rate in blacks lower after cardiac arrest

Not many patients survive after a cardiac arrest in a hospital, but the rates of survival fall even further when it comes to blacks. Survival rate is only 25 percent for blacks when compared to 37 percent for whites.

Lead researcher Dr. Paul S. Chan, a cardiologist at St. Luke’s Mid-America Heart Institute in Kansas City, was quoted as saying, “We know that survival after having a cardiac arrest in the hospital setting has always been historically low. The rate of survival has been about 30 to 33 percent on average.”

He further added, “This 12 percent absolute difference in survival is larger than any survival I can think of in terms of a racial disparity, in any other medical condition.”

Recovery rate low for blacks
For the current study purposes, Chan and his colleagues utilized statistics from the National Registry of Cardiopulmonary Resuscitation to analyze variations in survival among patients with in-hospital cardiac arrest.

Data on 10,011 patients from 274 hospitals was collected. Out of these, about 19 percent patients were black. All these patients had been defibrillated after a cardiac arrest. Defibrillation involves giving a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator.

It was found that the recovery rate for blacks was only 55.8 percent in comparison to 67.4 percent for whites. Even if they recovered, the survival rate after recovery was only 45.2 percent for blacks while the statistics stood at 55.5 percent for whites, the researchers noted.

Hospital plays a vital role
Explaining the reason behind these statistics, Chan said, “Black patients were sicker when they had a cardiac arrest than white patients.” Also, the hospital in which black patients got admitted did make a lot of difference.

This suggests that black patients were having cardiac arrests in hospitals that had a very less overall survival rate for all their patients. This is in comparison to white patients who went to hospitals that had a better survival rate, Chan added.

He said, “The hospital effect is huge and substantial, and is a contributor to the difference between black and white survival. If we can improve survival in those lower-performing hospitals at which black patients are more likely to be having cardiac arrest, we can eventually narrow the difference between black and white survival.”

The remaining difference in survival between blacks and whites could not be explained, Chan said.

Since there was no difference in the treatment received by blacks and whites, it cannot be established if racism has a role to play in the care given to blacks and whites.

“But it’s really hard to imagine that a physician would treat a black patient differently than a white patient during a cardiac arrest,” Chan said.

Expressing shock over the results, Dr. Kim A. Williams, director of nuclear cardiology at the University of Chicago, said, “I am truly shocked at the results -- only 11 percent less initial resuscitation success.”

“I thought the differential was far greater than this study demonstrates, but I am not surprised that the results are being attributed, at least in part, to the facilities involved rather than just the co-morbidities of the patients.”

The latest report has been published in the Sept. 16 issue of the Journal of the American Medical Association.