Elsevier

Resuscitation

Volume 145, December 2019, Pages 56-62
Resuscitation

Clinical paper
Ethnic disparities in the incidence and outcome from out-of-hospital cardiac arrest: A New Zealand observational study

https://doi.org/10.1016/j.resuscitation.2019.09.026Get rights and content
Under a Creative Commons license
open access

Abstract

Background

New Zealand (NZ) has an ethnically diverse population. International studies have demonstrated significant differences in health equity by ethnicity; however, there is limited evidence in the context of out-of-hospital cardiac arrest in NZ. We investigated whether heath disparities in incidence and outcome of out-of-hospital cardiac arrest exist between NZ ethnic groups.

Method

A retrospective observational study was conducted using NZ cardiac arrest registry data for a 2-year period. Ethnic cohorts investigated were the indigenous Māori population, Pacific Peoples and European/Others. Incidence rates, population characteristics and outcomes (Return of Spontaneous Circulation sustained to hospital handover and thirty-day survival) were compared.

Results

Age-adjusted incidence rates per 100,000 person-years were higher in Māori (144.4) and Pacific Peoples (113.5) compared to European/Others (93.8). Return of spontaneous circulation sustained to hospital handover was significantly lower in Māori (adjusted OR 0.74, 95% CI 0.64–0.87, p < 0.001). Survival to thirty-days was lower for both Māori (adjusted OR 0.61, 95% CI 0.48–0.78, p < 0.001) and Pacific Peoples (adjusted OR 0.52, 95% CI 0.37–0.72, p < 0.001). A higher proportion of events occurred in all age groups below 65 years old in Māori and Pacific Peoples (p < 0.001), and a higher proportion of events occurred among women in Māori and Pacific Peoples (p < 0.001).

Conclusions

There are significant differences in health equity by ethnicity. Both Māori and Pacific Peoples have higher incidence of out-of-hospital cardiac arrest and at a younger age. Māori and Pacific Peoples have lower rates of survival to thirty-days. Our results provide impetus for targeted health strategies for at-risk ethnic populations.

Keywords

Ethnic health inequalities
Māori
Pacific Peoples
Out-of-hospital cardiac arrest
Emergency medical service
Paramedic

Cited by (0)