scholarly journals Racial and Socioeconomic Disparities in Out-Of-Hospital Cardiac Arrest Outcomes: Artificial Intelligence-Augmented Propensity Score and Geospatial Cohort Analysis of 3,952 Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Dominique J. Monlezun ◽  
Alfred T. Samura ◽  
Ritesh S. Patel ◽  
Tariq E. Thannoun ◽  
Prakash Balan
Keyword(s):  
Artificial Intelligence ◽  
Cardiac Arrest ◽  
African Americans ◽  
Cohort Analysis ◽  
Safety Net ◽  
Socioeconomic Disparities ◽  
Lower Percentage ◽  
Median Income ◽  
Safety Net Hospital ◽  
Hospital Cardiac Arrest

Introduction. Social disparities in out-of-hospital cardiac arrest (OHCA) outcomes are preventable, costly, and unjust. We sought to perform the first large artificial intelligence- (AI-) guided statistical and geographic information system (GIS) analysis of a multiyear and multisite cohort for OHCA outcomes (incidence and poor neurological disposition). Method. We conducted a retrospective cohort analysis of a prospectively collected multicenter dataset of adult patients who sequentially presented to Houston metro area hospitals from 01/01/07-01/01/16. Then AI-based machine learning (backward propagation neural network) augmented multivariable regression and GIS heat mapping were performed. Results. Of 3,952 OHCA patients across 38 hospitals, African Americans were the most likely to suffer OHCA despite representing a significantly lower percentage of the population (42.6 versus 22.8%; p < 0.001 ). Compared to Caucasians, they were significantly more likely to have poor neurological disposition (OR 2.21, 95%CI 1.25–3.92; p = 0.006 ) and be discharged to a facility instead of home (OR 1.39, 95%CI 1.05–1.85; p = 0.023 ). Compared to the safety net hospital system primarily serving poorer African Americans, the university hospital serving primarily higher income commercially and Medicare insured patients had the lowest odds of death (OR 0.45, p < 0.001 ). Each additional $10,000 above median household income was associated with a decrease in the total number of cardiac arrests per zip code by 2.86 (95%CI -4.26- -1.46; p < 0.001 ); zip codes with a median income above $54,600 versus the federal poverty level had 14.62 fewer arrests ( p < 0.001 ). GIS maps showed convergence of the greater density of poor neurologic outcome cases and greater density of poorer African American residences. Conclusion. This large, longitudinal AI-guided analysis statistically and geographically identifies racial and socioeconomic disparities in OHCA outcomes in a way that may allow targeted medical and public health coordinated efforts to improve clinical, cost, and social equity outcomes.

scholarly journals 338 Factors Associated With Colonoscopy No-Show Among African Americans in an Urban Safety-Net Hospital

2019 ◽  
Vol 114 (1) ◽  
pp. S200-S200
Author(s):  
Suaka Kagbo-Kue ◽  
Iloabueke Chineke ◽  
Taiwo Ajose ◽  
Keerthi Padooru ◽  
Florence Iloh ◽  
...  
Keyword(s):  
African Americans ◽  
Safety Net ◽  
Factors Associated ◽  
Safety Net Hospital ◽  
Urban Safety

An Examination of John Henryism, Trust, and Medication Adherence Among African Americans With Hypertension

2019 ◽  
Vol 47 (1) ◽  
pp. 162-169
Author(s):  
Yendelela L. Cuffee ◽  
Lee Hargraves ◽  
Milagros Rosal ◽  
Becky A. Briesacher ◽  
Jeroan J. Allison ◽  
...  
Keyword(s):  
Medication Adherence ◽  
African Americans ◽  
Confidence Interval ◽  
Health Behaviors ◽  
Safety Net ◽  
The Body ◽  
John Henryism ◽  
Point Increase ◽  
Safety Net Hospital ◽  
Using Data

Background. John Henryism is defined as a measure of active coping in response to stressful experiences. John Henryism has been linked with health conditions such as diabetes, prostate cancer, and hypertension, but rarely with health behaviors. Aims. We hypothesized that reporting higher scores on the John Henryism Scale may be associated with poorer medication adherence, and trust in providers may mediate this relationship. Method. We tested this hypothesis using data from the TRUST study. The TRUST study included 787 African Americans with hypertension receiving care at a safety-net hospital. Ordinal logistic regression was used to examine the relationship between John Henryism and medication adherence. Results. Within our sample of African Americans with hypertension, lower John Henryism scores was associated with poorer self-reported adherence (low, 20.62; moderate, 19.19; high, 18.12; p < .001). Higher John Henryism scores were associated with lower trust scores (low John Henryism: 40.1; high John Henryism: 37.9; p < .001). In the adjusted model, each 1-point increase in the John Henryism score decreased the odds of being in a better cumulative medication adherence category by a factor of 4% (odds ratio = 0.96, p = .014, 95% confidence interval = 0.93-0.99). Twenty percent of the association between medication adherence and John Henryism was mediated by trust (standard deviation = 0.205, 95% confidence interval = 0.074-0.335). Discussion. This study provides important insights into the complex relationship between psychological responses and health behaviors. It also contributes to the body of literature examining the construct of John Henryism among African Americans with hypertension. Conclusion. The findings of this study support the need for interventions that promote healthful coping strategies and patient–provider trust.

scholarly journals Physician Presence in an Ambulance Car Is Associated with Increased Survival in Out-of-Hospital Cardiac Arrest: A Prospective Cohort Analysis

PLoS ONE ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e84424 ◽  
Author(s):  
Akihito Hagihara ◽  
Manabu Hasegawa ◽  
Takeru Abe ◽  
Takashi Nagata ◽  
Yoshihiro Nabeshima
Keyword(s):  
Cardiac Arrest ◽  
Prospective Cohort ◽  
Cohort Analysis ◽  
Hospital Cardiac Arrest

scholarly journals Comparison of Diabetes Control Among Haitians, African Americans, and Non-Hispanic Whites in an Urban Safety-Net Hospital

Diabetes Care ◽  
2010 ◽  
Vol 34 (1) ◽  
pp. 58-60 ◽  
Author(s):  
V. G. Vimalananda ◽  
J. L. Rosenzweig ◽  
H. J. Cabral ◽  
M. M. David ◽  
K. E. Lasser
Keyword(s):  
African Americans ◽  
Safety Net ◽  
Diabetes Control ◽  
Safety Net Hospital ◽  
Urban Safety

scholarly journals Early Bronchoscopy Improves Extubation Rates after Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Analysis

2021 ◽  
Vol 10 (14) ◽  
pp. 3055
Author(s):  
Gregor S. Zimmermann ◽  
Jana Palm ◽  
Anna Lena Lahmann ◽  
Friedhelm Peltz ◽  
Rainer Okrojek ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Arrest ◽  
Hospital Admission ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Optimal Timing ◽  
Test Results ◽  
Microbiological Test ◽  
Retrospective Cohort Analysis ◽  
Hospital Cardiac Arrest

Background: Patients suffering from out-of-hospital cardiac arrest (OHCA) frequently receive a bronchoscopy after being admitted to the ICU. We investigated the optimal timing and the outcome in these patients. Methods: All patients who suffered from OHCA and were treated in our ICU from January 2013 to December 2018 were retrospectively analyzed. The data were collected from the patients’ medical files, and included duration of mechanical ventilation, antibiotics, microbiological test results and neurological outcome. The outcome was the effect of early bronchoscopy (≤48 h after administration) on the rate of intubated patients on day five and day seven. Results: From January 2013 to December 2018, 190 patients were admitted with OHCA. Bronchoscopy was performed in 111 patients out of the 164 patients who survived the first day. Late bronchoscopy >48 h was associated with higher rates of intubation on day five (OR 4.94; 95% CI 1.2–36.72, 86.7% vs. 55.0%, p = 0.036) and day seven (OR 4.96; 95% CI 1.38–24.69; 80.0% vs. 43.3%, p = 0.019). Conclusion: This study shows that patients who suffered from OHCA might have a better outcome if they receive a bronchoscopy early after hospital admission. Our data suggests an association of early bronchoscopy with a shorter intubation period.

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