Black people are less likely to survive after being given cardiopulmonary resuscitation by a bystander.

New NIH-funded study reveals that race and gender matter when it comes to survival rates when CPR is performed by a bystander. The research, first published within the American Heart Association Journal, found that black people and ladies are less likely to survive when CPR is performed by a bystander, compared with white people.

The researchers analyzed data from what they call a “large U.S. registry.” They identified greater than 623,300 nontraumatic out-of-hospital cardiac arrests from 2013 to 2022 for a cohort study to determine whether there was a differential association between bystander CPR and survival outcomes by patient sex, race, and ethnicity overall, and by neighborhood strata.

They found that whites were thrice more likely to survive when CPR was administered after cardiac arrest. The study also found that men from any background were twice as likely to survive as women. It is essential to note that in all cases studied, CPR was performed by someone aside from a rescuer.

“CPR saves lives—we know that,” said Paula Einhorn, MD, PhD, program officer on the National Heart, Lung, and Blood Institute (NHLBI) at NIH. “But the disparities revealed in this study show that we need to do more to understand how to ensure equitable outcomes for all patients who need CPR. We hope that these new insights will lead to improved survival for these patient groups.”

According to the NIH, about 40% of adults who experience cardiac arrest received CPR from a bystander who was not a part of the emergency response team. This might be a member of the family, friend, or member of the general public. Distressed patients who received CPR from a bystander were 28% more likely to survive compared with those that didn’t receive CPR from a bystander. They were also more likely to survive without serious brain injury.

“It’s not just about whether CPR was performed by a bystander, but whether it was performed well for everyone, so that regardless of race, ethnicity, or gender, everyone could benefit equally from someone starting CPR?” asked Dr. Paul Chan, MD, the study’s first writer, who asked the query. Dr. Chan can also be a cardiologist at Saint Luke’s Mid-America Heart Institute in Kansas City, Missouri.

He adds: “These results suggest that we need to have a more nuanced understanding of how survival is improved and whether bystander CPR provides similar survival benefits for all patients.”