BACKGROUND Bystander cardiopulmonary resuscitation (CPR) is associated with higher survival for out-of-hospital cardiac arrest, but whether its association with survival differs by patients' sex and race and ethnicity is less clear. METHODS Within a large US registry, we identified 623 342 nontraumatic out-of-hospital cardiac arrests during 2013 to 2022 for this observational cohort study. Using hierarchical logistic regression, we examined whether there was a differential association between bystander CPR and survival outcomes by patients' sex and race and ethnicity, overall and by neighborhood strata. RESULTS Mean age was 62.1±17.1 years, and 35.9% were women. Nearly half of patients (49.8%) were non-Hispanic White; 20.6% were non-Hispanic Black; 7.3% were Hispanic; 2.9% were Asian; and 0.4% were Native American. Overall, 58 098 (9.3%) survived to hospital discharge. Although bystander CPR was associated with higher survival in each race and ethnicity group, the association of bystander CPR compared with patients without bystander CPR in each racial and ethnic group was highest in individuals who were White (adjusted odds ratio [OR], 1.33 [95% CI, 1.30-1.37]) and Native American (adjusted OR, 1.40 [95% CI, 1.02-1.90]) and lowest in individuals who were Black (adjusted OR, 1.09 [95% CI, 1.04-1.14]; Pinteraction<0.001). The adjusted OR for bystander CPR compared with those without bystander CPR for Hispanic patients was 1.29 (95% CI, 1.20-1.139), for Asian patients, it was 1.27 (95% CI, 1.12-1.42), and for those of unknown race, it was 1.31 (95% CI, 1.25-1.36). Similarly, bystander CPR was associated with higher survival in both sexes, but its association with survival was higher in men (adjusted OR, 1.35 [95% CI, 1.31-1.38]) than women (adjusted OR, 1.15 [95% CI, 1.12-1.19]; Pinteraction<0.001). The weaker association of bystander CPR in Black individuals and women was consistent across neighborhood race and ethnicity and income strata. Similar results were observed for the outcome of survival without severe neurological deficits. CONCLUSIONS Although bystander CPR was associated with higher survival in all patients, its association with survival was weakest for Black individuals and women with out-of-hospital cardiac arrest.

中文翻译：

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心脏骤停旁观者心肺复苏协会中的种族和性别差异。


背景旁观者心肺复苏（CPR）与院外心脏骤停的较高生存率相关，但其与生存率的相关性是否因患者性别、种族和民族而异尚不清楚。方法 在这项观察性队列研究中，我们在 2013 年至 2022 年期间在美国大型登记处确定了 623 342 例非外伤性院外心脏骤停患者。使用分层逻辑回归，我们检查了旁观者心肺复苏与患者的生存结果之间是否存在差异关联，这些关联取决于患者的性别、种族和民族、整体以及邻里阶层。结果 平均年龄为 62.1±17.1 岁，其中 35.9% 为女性。近一半的患者（49.8%）是非西班牙裔白人； 20.6% 是非西班牙裔黑人； 7.3% 是西班牙裔； 2.9% 为亚洲人； 0.4% 是美洲原住民。总体而言，58 098 人 (9.3%) 存活至出院。尽管旁观者 CPR 与每个种族和民族群体的较高生存率相关，但与每个种族和民族群体中没有旁观者 CPR 的患者相比，白人个体中旁观者 CPR 的相关性最高（调整后的比值比 [OR]，1.33 [95] % CI，1.30-1.37]）和美洲原住民（调整后 OR，1.40 [95% CI，1.02-1.90]），黑人个体中最低（调整后 OR，1.09 [95% CI，1.04-1.14]；Pinteraction% 3C0.001）。与没有旁观者 CPR 的患者相比，西班牙裔患者的旁观者 CPR 调整后 OR 为 1.29 (95% CI, 1.20-1.139)，亚洲患者为 1.27 (95% CI, 1.12-1.42)，而对于未知种族患者则为 1.27 (95% CI, 1.12-1.42) ，为 1.31（95% CI，1.25-1.36）。同样，旁观者心肺复苏与男女生存率较高相关，但男性（调整后 OR，1.35 [95% CI，1.31-1.38]）与生存率的相关性高于女性（调整后 OR，1.15 [95% CI，1]）。 。12-1.19]； Pinteraction<0.001)。黑人和女性中旁观者心肺复苏的较弱关联在社区种族、民族和收入阶层中是一致的。对于没有严重神经功能缺损的生存结果，也观察到了类似的结果。结论 虽然旁观者心肺复苏与所有患者的较高生存率相关，但对于黑人和院外心脏骤停的女性来说，旁观者心肺复苏与生存的相关性最弱。