Background: Cardiac arrest is a major cause of in-hospital mortality and morbidity. Despite advances in treatment and several interventions to target mortality and improve outcomes, cardiac arrest continues to be a major cause of morbidity and mortality. The aim of this study was to examine outcomes of cardiac arrest patients. In addition to mortality, length of stay and direct costs were also analyzed to examine resource utilization in this condition.
Methods: ICD-10 diagnosis codes were utilized to identify patients in the Vizient database, a large administrative database. Patients admitted with a principal diagnosis of cardiac arrest between 2015-2017 were included in the study. Outcomes analyzed in the study include mortality, length of stay, ICU utilization and direct costs. Outcomes were also analyzed to examine if differences existed based on race, gender and age. Further, outcomes were examined based on discharge disposition.
Results: A total of 96,171 patients with cardiac arrest during the study period were included in the study. Overall mortality due to cardiac arrest was observed to be 61.91% and 75.42% required ICU care. Mean length of stay was 11.95 days and direct costs were $ 30,012. Men showed higher length of stay (12.31 ± 21.16 days in male vs 11.44 ± 20.06 days in female; p<0.0001), costs ($ 31,889 ± 53,279 in male vs $ 27,347 ± 46,439 in female; p<0.0001) and ICU admission but lower mortality (60.73% in male vs 63.58% in female; p<0.0001). African-Americans showed overall poor outcomes compared to Caucasians. Length of stay (10.96 days in Caucasians vs 13.98 days in African-Americans; p<0.0001) and costs were significantly higher in African-Americans. Mortality was higher in African-Americans as well (60.28% in Caucasians vs 63.02% in African-Americans; p<0.0001). As age increased, mortality increased significantly compared to younger age groups. Length of stay and costs were higher in the younger age groups compared to older age groups. Analysis of discharge disposition for these patients showed that only 17.11% of patients were discharged home with self-care or home with home health care. An additional 14.06% of patients were discharged to skilled nursing facility or rehabilitation facility after a prolonged hospitalization course. Further 3.12% of patients with cardiac arrest were discharged on hospice and 61.91% expired.
Conclusions: Outcomes in patients with cardiac arrest are poor with extremely high mortality. Significant gender differences in outcomes were noted with men with slightly higher resource utilization but lower mortality. Outcomes in African-Americans were overall worse than Caucasians. As age increased, mortality increased in the older age groups. Younger age groups showed higher length of stay and costs. Analysis of discharge disposition showed that cardiac arrest has a very high mortality. Even in patients who survived, majority of patients required rehabilitation and only small percentage were able to be discharged home.