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    Hispanic/Latino-Serving Hospitals Provide Less Targeted Temperature Management Following Out-of-Hospital Cardiac Arrest

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    Author
    Morris, Nicholas A
    Mazzeffi, Michael
    McArdle, Patrick
    May, Teresa L
    Waldrop, Greer
    Perman, Sarah M
    Burke, James F
    Bradley, Steven M
    Agarwal, Sachin
    Figueroa, Jose F
    Badjatia, Neeraj
    Show allShow less

    Date
    2021-11-08
    Journal
    Journal of the American Heart Association
    Publisher
    Wiley-Blackwell
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1161/JAHA.121.023934
    Abstract
    Background Variation exists in outcomes following out-of-hospital cardiac arrest (OHCA), but whether racial and ethnic disparities exist in post-arrest provision of targeted temperature management (TTM) is unknown. Methods and Results We performed a retrospective analysis of a prospectively collected cohort of patients who survived to admission following OHCA from the Cardiac Arrest Registry to Enhance Survival, whose catchment area represents ~50% of the United States from 2013-2019. Our primary exposure was race/ethnicity and primary outcome was utilization of TTM. We built a mixed-effects model with both state of arrest and admitting hospital modeled as random intercepts to account for clustering. Among 96,695 patients (24.6% Black, 8.0% Hispanic/Latino, 63.4% White), a smaller percentage of Hispanic/Latino patients received TTM than Black or White patients (37.5% vs. 45.0 % vs 43.3%, P < .001) following OHCA. In the mixed-effects model, Black patients (Odds Ratio [OR] 1.153, 95% Confidence Interval [CI] 1.102-1.207, P < .001) and Hispanic/Latino patients (OR 1.086, 95% CI 1.017-1.159, P < .001) were slightly more likely to receive TTM compared to White patients, perhaps due to worse admission neurological status. We did find community level disparity as Hispanic/Latino-serving hospitals (defined as the top decile of hospitals that cared for the highest proportion of Hispanic/Latino patients) provided less TTM (OR 0.587, 95% CI 0.474 to 0.742, P < .001). Conclusions Reassuringly, we did not find evidence of intrahospital or interpersonal racial or ethnic disparity in the provision of TTM. However, we did find inter-hospital, community level disparity. Hispanic/Latino-serving hospitals provided less guideline-recommended TTM after OHCA.
    Keyword
    Cardiac Arrest
    Disparities
    Race/Ethnicity
    Targeted Temperature Management
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17166
    ae974a485f413a2113503eed53cd6c53
    10.1161/JAHA.121.023934
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