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Mortality from cardiac arrest in US emergency departments

Mortality from cardiac arrest in US emergency departments

TOPLINE:

Disparities in emergency department (ED) mortality and patient outcomes following cardiac arrest in the United States highlight the urgent need for equitable health care 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 emergency room visits between 2016 and 2020 were included needed.
  • Both patient and hospital characteristics were recorded.
  • The primary outcome was emergency department mortality; The secondary outcome was the patient’s disposition from the emergency department.

TAKE AWAY:

  • Of the patients who suffered cardiac arrest, 52.6% died in the emergency department and 4.8% were transferred to another hospital; Combined ED and inpatient mortality increased from 71.9% to 73.8% in 2016-2019 to 75.4% in 2020.
  • The risk of ED mortality increased with income and age, with the highest risk observed in patients aged 50 to 69 years (adjusted odds ratio). [aOR]1.71; P <.001 and="" above="" years="">P <.001 and="" in="" those="" with="" a="" median="" annual="" household="" income=""> $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 ED mortality rates 21%, 10%, and 19% lower, respectively, than white patients.
  • The risk of ED mortality was higher in patients with more than four Elixhauser comorbidities (OR: 1.18; P =.035) than in patients with four or fewer Elixhauser comorbidities

IN PRACTICE:

“Our results demonstrated significant disparities in ED mortality and patient disposition after cardiac arrest, highlighting the need for equitable health care and policy,” the authors write.

SOURCE:

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

RESTRICTIONS:

The study was limited by its retrospective design and data limitations, including reliance on pre-existing data, lack of detailed information on clinical parameters, limitation of the data set to EDs and inpatient mortality, self-reported racial and ethnic data, and inability to Differentiation between the primary and secondary diagnosis of cardiac arrest and the presence of potential unmeasured confounders. The study’s reliance on administrative data may also have limited its transferability to nonhospital emergency care settings.

DISCLOSURES:

No external funding was obtained for the study. The authors stated that there was no conflict of interest.

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