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Invited Commentary
September 2017

Racial Differences in In-Hospital Cardiac Arrest: Good News: Cautious Optimism Is Welcome

Author Affiliations
  • 1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Department of Emergency Medicine, Hofstra Northwell School of Medicine, Manhasset, New York
  • 3North Shore University Hospital, Northwell Health, Manhasset, New York
  • 4Long Island Jewish Medical Center, Manhasset, New York
  • 5Feinstein Institute for Medical Research, Manhasset, New York
JAMA Cardiol. 2017;2(9):984-985. doi:10.1001/jamacardio.2017.2432

Studies of cardiac resuscitation initially alerted us to major disparities in survival between black and white Americans in the out-of-hospital cardiac arrest setting.1,2 The disadvantage of black race was striking, and multiple possible factors were cited, including lower rates of bystander cardiopulmonary resuscitation (CPR),3 the effect of neighborhoods, socioeconomic factors, comorbidities, and delayed arrival of emergency medical services personnel. It was equally disappointing when studies of in-hospital arrest by the American Heart Association Get With the Guidelines (GWTG) registry recorded similarly lower survival in black individuals despite the fact that in-hospital identification of cardiac arrest, performance of CPR and defibrillation, and upgrading of in-patient care should not differ by race/ethnicity. This initial study from the GWTG registry detailed strikingly lower survival to hospital discharge for black patients in general and, more specifically, within hospitals with a higher predominance of black patients.4