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dc.contributor.authorMorris, Nicholas A
dc.contributor.authorMazzeffi, Michael
dc.contributor.authorMcArdle, Patrick
dc.contributor.authorMay, Teresa L
dc.contributor.authorWaldrop, Greer
dc.contributor.authorPerman, Sarah M
dc.contributor.authorBurke, James F
dc.contributor.authorBradley, Steven M
dc.contributor.authorAgarwal, Sachin
dc.contributor.authorFigueroa, Jose F
dc.contributor.authorBadjatia, Neeraj
dc.date.accessioned2021-11-18T19:27:57Z
dc.date.available2021-11-18T19:27:57Z
dc.date.issued2021-11-08
dc.identifier.urihttp://hdl.handle.net/10713/17166
dc.description.abstractBackground 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.en_US
dc.description.urihttps://doi.org/10.1161/JAHA.121.023934en_US
dc.language.isoenen_US
dc.publisherWiley-Blackwellen_US
dc.relation.ispartofJournal of the American Heart Associationen_US
dc.subjectCardiac Arresten_US
dc.subjectDisparitiesen_US
dc.subjectRace/Ethnicityen_US
dc.subjectTargeted Temperature Managementen_US
dc.titleHispanic/Latino-Serving Hospitals Provide Less Targeted Temperature Management Following Out-of-Hospital Cardiac Arresten_US
dc.typeArticleen_US
dc.identifier.doi10.1161/JAHA.121.023934
dc.identifier.pmid34743562
dc.source.beginpagee017773
dc.source.endpage
dc.source.countryEngland


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