In-hospital heart attacks and race

NEW YORK In-hospital heart attack survival may not be so much a difference in how people of different races are treated in the hospital, but whether the hospital itself performs well or poorly. That was the finding in a report from this week's Journal of the American Medical Association.

Hospital staff understand that when a patient has a cardiac arrest, resuscitation attempts must happen immediately.

"The patient's heart is stopped," Dr. Paul Chan said. "They've stopped breathing and there's no electrical or mechanical activity of the heart."

Dr. Chan, of St. Luke's Mid America Heart Institute, and his colleagues felt that these in-hospital emergency events provided a unique opportunity to look at whether medical treatment - and ultimately survival - differed between black and white patients.

Their research examined the survival rates of more than 10,000 patients within a standardized national registry who required CPR or defibrillation following an in-hospital cardiac arrest.

The study found that black patients had slightly more than a 25 percent survival rate to hospital discharge, while white patients survived more than 37 percent of the time.

However, that 12 percent gap was substantially narrowed after researchers took into account the hospital where treatment was received. Experts say finding ways of improving the quality of resuscitation and post-resuscitation care in these under-performing hospitals will be crucial to eliminating survival differences by race.

"Some hospitals are better performers when it comes to resuscitating and providing the best possible care for patients with cardiac arrest than other hospitals," Dr. Chan said. "And these differences seem to disproportionately affect patients who are black."

Researchers found no evidence of significant differences by race in the amount or agressiveness of CPR. The study also hinted that there could be a difference between the races in access to care and disease prevention before patients were hospitalized.

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WEB PRODUCED BY: Bill King

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