Abstract

Objective: To compare out of hospital cardiac arrest (OOHCA) characteristics in White and South Asian populations within Greater London.

Methods: Data for OOHCAs were extracted from 1st April 2003 to 31st March 2007. Primary study variables included age, gender, ethnicity, response times from 999 call to ambulance arrival, initial cardiac rhythm, whether bystander CPR was provided prior to arrival of the London Ambulance Service NHS Trust (LAS) crew, whether the arrest was witnessed (bystander or LAS crew) and hospital outcome including survival to hospital admission and discharge.

Results: Of 13,013 OOHCAs of presumed cardiac cause 3161 (24.3%) had ethnicity codes assigned. These comprised of 63.1% (n=1995) White and 5.8% (n=183) South Asian people with the remaining from other backgrounds. White patients were on average five years older than South Asians (69.5 Vs 64.6, p<0.005). Response time (7.48 mins Vs 7.46 mins), bystander CPR (34.4% versus 29.7%), initial cardiac rhythm (29.5% versus 30.4%), and survival to admission (22.2% versus 22.5%) and discharge (8.7% versus 8.9%) were comparable between the two ethnic groups. South Asians were slightly more likely to have a witnessed OOHCA compared to their White counterparts (OR 1.1, 95% CI 1.0–1.2).

Discussion: The quality of care provided was comparable between White and South Asian populations. The data support the emerging view that South Asians’ high mortality from CHD reflects higher incidence rather than higher case fatality. South Asian had OOHCA at a significantly younger age. The study demonstrates the importance of ethnic coding within the emergency services.