Steven Reinberg, HealthDay, September 15, 2009
Black patients who suffer cardiac arrest in the hospital are much less likely to survive than white patients, a new study finds.
Most of this disparity appears to result from the hospital in which black patients receive care, although other factors play a role as well, the researchers said.
“We know that survival after having a cardiac arrest in the hospital setting has always been historically low,” said lead researcher Dr. Paul S. Chan, a cardiologist at St. Luke’s Mid-America Heart Institute in Kansas City. “The rate of survival has been about 30 to 33 percent on average.”
But the survival rates for blacks were significantly lower, 25 percent vs. 37 percent for whites, Chan said.
“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,” he said.
The report is published in the Sept. 16 issue of the Journal of the American Medical Association.
The lower rates of survival to hospital discharge for blacks reflected lower rates of successful resuscitation (55.8 percent for blacks vs. 67.4 percent for whites) and survival after resuscitation (45.2 percent for blacks vs. 55.5 percent for whites), the researchers noted.
About a third of the difference can be explained by the patients themselves, Chan said, “Black patients were sicker when they had a cardiac arrest than white patients,” he said.
Another third of the difference was explained by the hospitals many black patients were in, Chan said.
In addition, the quality of care after resuscitating a patient was worse in hospitals treating mostly black patients compared with care in hospitals treating white patients, Chan said.
The remaining difference in survival between blacks and whites could not be explained, Chan said.
There did not seem to be a difference between the treatment blacks and whites received, so racism did not seem to play a role in care between blacks and whites, he said.
“We cannot exclude it fully,” Chan said. “But it’s really hard to imagine that a physician would treat a black patient differently than a white patient during a cardiac arrest.”
[Editors Note: The abstract for “Racial Differences in Survival After In-Hospital Cardiac Arrest,” by Paul S. Chan, et al. can be read here. The complete article and related materials are available on the same page; there is a charge for accessing them.]