(172) Unveiling Inequities: Cardiac Arrest Outcomes Across Socioeconomic, Racial, and Hospital Lines

Introduction: This study re-evaluates the influence of racial, socioeconomic, and hospital-related factors on cardiac arrest survival rates using the National Inpatient Sample database from 2017 to 2021, providing updated insights into these disparities.

Methods: This retrospective study analyzed 1,257,275 adult cardiac arrest admissions. Survey-weighted logistic regression was used to adjust for factors such as age, sex, and key comorbidities (arrhythmias, heart failure, ischemic heart disease, pulmonary embolism, hypertension, diabetes, and kidney disease), the Charlson Comorbidity Index. The mortality rate for cardiac arrest was evaluated by race, hospital characteristics (bed size, teaching status, location), and socioeconomic status, which was determined by income quartiles derived from patient ZIP codes.

Results: Over five years, there were 855.24 cardiac arrests per 100,000 adult admissions; the mean age was 65.4, with males accounting for 58.07%. Cardiac arrest prevalence was highest among Whites (62.24%), followed by Blacks (19.74%), Hispanics (10.99%), Asians (2.98%), and Native Americans (0.69%). The overall survival rate stood at 37.07%. Adjusted mortality was highest among Asians (OR: 1.353, 95% CI: 1.282-1.429, p< 0.001) and Hispanics (OR: 1.298, 95% CI: 1.253-1.345, p< 0.001), with no significant differences noted for Blacks or Native Americans compared to Whites. Mortality disparities by income showed 64.764% in the lowest quartile versus 61.168% in the highest (OR: 0.857, 95% CI: 0.832-0.882, p< 0.001). The lowest mortality rate was observed in those with private insurance (55.818%), significantly lower than Medicare recipients (OR: 0.668, 95% CI: 0.652-0.684, p< 0.001). Urban areas had a reduced mortality rate compared to rural areas (OR: 0.948, 95% CI: 0.899-0.999, p=0.047). Mortality was also lower in teaching hospitals (OR: 0.928, 95% CI: 0.900-0.957, p< 0.001) and decreased in large hospitals compared to small (OR: 0.9, 95% CI: 0.871-0.932, p< 0.001).

Conclusions: The study revealed disparities in cardiac arrest outcomes linked to race, socioeconomic status, insurance type, and hospital characteristics. It highlights the need to improve healthcare equity, especially for patients with varying insurance coverage and those in non-teaching or rural hospitals.