Jean-Sebastien Rachoin, MBA, MD
Associate Professor of Medicine
Cooper University Hospital
Cherry Hill, NJ
Disclosure information not submitted.
Phillip Olsen, MD
Medical Resident
Cooper University Healthcare, United States
Disclosure information not submitted.
John Gaughan, Phd
Professor of Medicine
Cooper University Healthcare, United States
Disclosure information not submitted.
Elizabeth Cerceo, MD
Associate Professor of Medicine
Cooper University Healthcare, United States
Disclosure information not submitted.
Title: Regional Racial differences in the USA after cardiac arrest: a longitudinal study from 2006-2018
Introduction: There are well-established disparities with numerous health outcomes among racial and ethnic minorities. Studies show that black patients (BP) are more likely to have worse outcomes overall after cardiac arrest (CA). The available data, however, have not compared regional differences after CA. We thus sought to investigate the impact of geographic differences and race in CA over time.
Methods: We performed a retrospective analysis of the National inpatient sample for patients discharged with CA between January 1, 2006 and December 31, 2018. We recorded demographic variables and the outcomes mortality, and length of stay (LOS). We analyzed differences between 4 regions: North East (NE), South (SO), West (W), and Midwest (MW)
Results: Over the study period, there were 464,499 patients with CA. The incidence of CA increased from 2006 (27,611) to 2018 (43,333). The proportion of BP with CA significantly increased from 11.9% to 18.8%. (p< 0.001). The mortality of CA decreased over time from 65.4% to 60.8% in all patients and 70.2% to 61.4% in BP (both p< 0.001). Mortality was higher in BP (62% vs 60.7%, p< 0.001). Over time, LOS decreased slightly from 9 days to 8.7 in all patients (p=0.03). The LOS for BP was higher than non-BP (11.3 vs 8.6 days, p< 0.001).
We then performed a multivariate analyses in all patients. For the outcome mortality, we found that BP was significantly associated with higher mortality (OR, 1.1 [1.08-1.11], p< 0.001). When regions were compared, W had the highest mortality risk followed by SO, NE, and MW. For the outcome LOS, BP had a higher LOS (OR 2[1.88-2.12]). Among the regions, NE had the highest LOS followed by SO, W, than MW. We then performed a multivariate analysis in BP only. For the mortality outcome, W had the highest risk followed by MW, NE, and SO. For LOS, NE was the highest followed by W, SO, and MW.
Conclusion: The proportion of BP with CA increased over the study period. Mortality and LOS improved significantly in BP from 2006 to 2018 but remain significantly higher than in other patients. There were regional differences for outcomes in all patients and in BP in particular.