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Ethnic disparities in the incidence and outcome from out-of-hospital cardiac arrest

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Authors:
Summary:

Māori and Pasifika had significantly higher incidences of out-of hospital cardiac arrest compared to European/Other ethnicities in a 2-year retrospective study of New Zealand cardiac arrest registry data. The age adjusted incidence rate per 100,000 person-years was 144.4 for Māori, 113.5 for Pasifika, and 93.8 for European/Other. Māori had significantly lower likelihood of return of spontaneous circulation sustained to hospital handover (OR 0.74; 95% CI 0.64–0.87; p<0.001) and survival to 30-days (OR 0.61; 95% CI 0.48–0.78; p<0.001) compared with European/Other. There was a significantly higher proportion of events in Māori and Pasifika aged <65 years and Māori and Pasifika women compared with their European/ Other counterparts.

Comment:
Really important to have this evidence. I’d love to understand why these inequities exist. Similar inequities were demonstrated between African American, Latino and White Americans in the US and on further investigation, though many thought it was related to the extent and type of coronary artery disease, there appeared to be differences in bystander resuscitation attempts by ethnicity of the person requiring CPR.
Reference: Resuscitation. 2019;145:56-62.
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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