(149) Cardiac Arrest in the United States: A Nationwide Retrospective Study From 2016 to 2020

Introduction: Cardiac arrest (CA) is a life-threatening medical emergency that has significant morbidity and mortality, posing a major public health concern. This study aims to understand the cost and demographic information of patients experiencing CA in the United States (US).

Methods: We performed a retrospective study utilizing the Healthcare Cost and Utilization Project’s (HCUP) National Emergency Department Sample (NEDS) database from 2016 to 2020. Emergency department (ED) visits among adult patients who have ICD-10 billing codes related to CA in the US were analyzed. Descriptive analyses utilized multiple patient-level variables from the HCUP core datasets, including age, sex, median household income of residing zip code, hospital characteristics, and cost of care.

Results: From 2016 to 2020, 1,883,507 patients sustained CA in the ED. Of those patients, 1,125,282 (60%) were male and 837,813 (44%) died in the ED. Majority of patients (1,120,767; 60%) lived in areas where median household income was in the 50th percentile or less for that year. The largest proportion of CA cases (832,280; 44%) occurred in the southern US region, followed by the Midwest (395,803, 21%). Nearly two-thirds of patients (1,201,274; 64%) presented to a metropolitan teaching hospital. Approximately half of all patients were treated at trauma centers compared to non-trauma centers (n=952,040; 51% vs. n=931,467; 49%). The mean total cost for ED services was $6,915 per CA patient, compared to the mean inpatient total cost of $160,483 per CA patient. Across our study period, the total ED and inpatient costs associated with CA was at least $145 billion.

Conclusions: Cardiac arrest (CA) is costly and resource intensive, with poor outcomes. CA is associated with a huge financial burden on the healthcare system. The majority of patients were from areas with low economic status. Future studies and preventative efforts should be directed at underserved and disadvantaged patient populations.