SYSTEMATIC REVIEW article
Front. Public Health
Sec. Disaster and Emergency Medicine
This article is part of the Research TopicImplementation Science for Disaster Preparedness and Emergency MedicineView all 4 articles
Racial Disparities, Comorbidities, and Low Body Mass Index Reduce Survival after Cardiopulmonary Resuscitation: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Tianjin University, Tianjin, China
- 2Wenzhou Safety Emergency Institute of Tianjin University, Wenzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction: CPR is crucial for the management of cardiac arrest. However, the impacts of certain individualized factors, such as different ethnicities, body weights, and medical histories, on the efficacy of CPR remain unclear. This meta - analysis clarifies the associations between three individualized factors and the outcomes of CPR, aiming to optimize resuscitation strategies. Methods: We systematically searched eight databases—PubMed, Web of Science, Scopus, Embase, Cochrane Library,VIP, Wan Fang, and CNKI—for studies that explored the associations between ethnicity, past medical history, body mass index (BMI), and CPR outcomes. Separate meta - analyses were then conducted for each of these three individualized factors. Results: Eleven studies evaluated ethnicity, nine assessed medical history, and eight analyzed BMI. White patients exhibited significantly higher survival rates than Black patients (OR=1.36, 95% CI [1.22–1.50], p<0.00001). Compared to patients with a medical history, patients without a medical history have a higher survival rate (OR=0.51, 95% CI [0.37–0.70], p<0.0001). Compared to standard weight groups (BMI 18.5-24.9 kg/m²), underweight individuals (BMI<18.5 kg/m2) had lower survival (OR=0.64, 95%CI[0.51-0.80],p=0.0001) and poorer neurological outcomes in underweight individuals (BMI<18.5 kg/m2) (OR=0.72,95%CI[0.55-0.94],p=0.01). No significant differences were observed in overweight/obese versus normal-weight patients. Discussion: This study demonstrates that ethnicity differences, pre-existing comorbidities, and low BMI can affect survival rates after CPR. These results are of great significance for clinical practice, suggesting that it is necessary to reduce inequalities in the distribution of medical resources in response to racial differences, optimize disease management for patients with comorbidities, and incorporate underweight status into high-risk assessment. Future research should further explore the underlying mechanisms and expand to more regions, so as to provide evidence for the construction of a personalized resuscitation medicine system and the formulation of guidelines.
Keywords: cardiopulmonary resuscitation1, survival rate2, ethnicity3, past medical history4, Body mass index5, meta-analysis6, Individualized factors7
Received: 11 Jul 2025; Accepted: 25 Nov 2025.
Copyright: © 2025 Du, Ma, Tong, Zhao, Chen, Fan, Hou and Fan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bin Fan
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.