Abstract
Aim
Healthcare disparities can affect access and quality of care among many in the United
States (US). In addition to race, we sought to assess if geography affected rates
of cardiac arrest, and the subsequent outcomes.
Methods
Using the National Inpatient Sample database from 2006–2018, we assessed rates of
cardiac arrest (out of hospital that survived to admission and in-hospital) and cardiac
catheterization, and length of stay (LOS) in four regions: Northeast (NE), South (SO)
West (W) and Midwest (MW).
Results
Cardiac arrest increased from 27,611 (2006) to 43,333 (2018). The proportion of African
American (AA) patients experiencing cardiac arrest significantly increased from 11.9%
to 18.8%. The mortality decreased from 65.4% to 60.8% in all patients and 70.2% to
61.4% in AA. Mortality in AA remained higher than non-AA (OR, 1.09 [1.08–1.11], p < 0.001). When regions were compared for mortality, MW had a lower risk than NE 0.94[0.92–9.96];
SO 1.05[1.04–1.07] and W 1.11[1.09–1.13] were higher compared to NE. LOS decreased
slightly from 9.0 days to 8.7 in all patients. LOS for AA was longer than non-AA (11.3
vs 8.6 days) with the NE having the longest LOS. AA were less likely to receive cardiac
catheterization than non-AA (9.5% vs 15%) with the largest racial gap in the MW region.
Conclusion
The proportion of AA with cardiac arrests increased over the study period. Mortality
and LOS improved significantly in AA from 2006 to 2018 but remain significantly higher
than non-AA patients. Future research should identify contributors to these concerning
trends.
Keywords
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Article info
Publication history
Published online: October 29, 2021
Accepted:
October 25,
2021
Received in revised form:
October 20,
2021
Received:
July 19,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
