Cardiac Arrest Mortality in US Emergency Departments

TOPLINE:

Disparities in emergency department (ED) mortality and patient outcomes after cardiac arrest in the United States emphasize an urgent need for equitable healthcare resources and policies.

METHODOLOGY:

• Researchers conducted a retrospective cohort analysis using the Nationwide Emergency Department Sample database.
• A total of 1,414,060 adults (mean age for men vs women, 63 years vs 66 years; 61% men; 25.42% White) who experienced cardiac arrest or required cardiopulmonary resuscitation during ED visits from 2016 to 2020 were included.
• Both patient and hospital characteristics were recorded.
• The primary outcome was mortality in the ED; the secondary outcome was patient disposition from the ED.

TAKEAWAY:

• Among the patients who experienced cardiac arrest, 52.6% died in the ED and 4.8% were transferred to another hospital; the combined ED and inpatient mortality increased from 71.9%- 73.8% in 2016-2019 to 75.4% in 2020.
• The risk for ED mortality increased with income and age, with the highest risk observed in patients aged 50-69 years (adjusted odds ratio [aOR], 1.71; P <.001 and="" above="" years="">P <.001 and="" in="" those="" with="" a="" median="" annual="" household="" income=""> USD 86,000 (OR 1.12; P <.001 self-payers="" had="" higher="" ed="" mortality="" rates="">P <.001 than="" patients="" insured="" by="" medicaid.="">
• Asian, Black, and Hispanic patients had 21%, 10%, and 19% lower ED mortality rates, respectively, than White patients.
• The risk for ED mortality was higher in patients with more than four Elixhauser comorbidities (OR, 1.18; P =.035) than in those with four or fewer Elixhauser comorbidities

IN PRACTICE:

“Our results showed significant disparities in ED mortality and patient disposition following cardiac arrest, highlighting the need for equitable healthcare resources and policies,” the authors wrote.

SOURCE:

The study was led by Kenneth M. Zabel, University of New Mexico, Albuquerque, New Mexico. It was published online on September 20, 2024, in the Journal of Clinical Medicine.

LIMITATIONS:

The study was limited by its retrospective design and data constraints, including reliance on preexisting data, lack of detailed information on clinical parameters, scope of the dataset being limited to EDs and inpatient mortality, racial and ethnic data being self-reported, inability to differentiate between primary and secondary diagnoses of cardiac arrest, and presence of potential unmeasured confounders. The study’s reliance on administrative data may also have limited its generalizability to non–hospital-based emergency care settings.

DISCLOSURES:

No external funding was received for the study. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.