Abstract 10707: The Impact of the COVID-19 Pandemic on Incidence and Outcomes from Out-of-Hospital Cardiac Arrest (OHCA) in Texas

Abstract

Introduction: Nationally, the COVID-19 pandemic was associated with worse OHCA outcomes. Whether these trends persist or were consistent between states is unclear. Purpose: To determine the impact of COVID-19 on OHCA incidence and outcomes in Texas between 2019-2020. Methods: We analyzed adult OHCAs in Texas from the Cardiac Arrest Registry to Enhance Survival (CARES) during a matched period (March 11-December 31 from 2019 through 2020). We excluded cases witnessed by 9-1-1 responders and arrests occurring at healthcare facilities. Outcomes were rates of BCPR, AED use, sustained ROSC, prehospital termination of resuscitation (TOR), survival to hospital, survival to hospital discharge, good neurological outcomes and Utstein bystander survival. We created a mixed effects logistic regression model analyzing the effect of the pandemic on outcomes, using EMS agency as the random intercept. We adjusted for age, gender, race/ethnicity, witnessed arrest, initial rhythm type and location type. Results: There were 8,070 OHCA cases, with 4,443 (55.1%) in the pandemic period (March 11 - December 31, 2020) and 3,627 (44.5%) from March 11 - December 31 2019, a relative 18.4% increase. There was a significantly decreased odds of BCPR (46.2% v 42.2%, aOR = 0.87, 95% CI 0.79-0.95), AED use (13.0% v 7.3%, aOR = 0.53, 95% CI 0.36-0.78), and sustained ROSC (28.8% v 21.2%, aOR = 0.67, 95% CI 0.60-0.74) during the pandemic. Survival to hospital (27.1% v 20.9%, aOR = 0.72, 95% CI 0.65-0.80) and survival to hospital discharge (10.0% v 7.4%, aOR = 0.71, 95% CI 0.64-0.89) also decreased. Prehospital TOR increased (37.3% v 46.7%, aOR = 1.51, 95% CI 1.35-1.67). The pandemic was associated with a lower Utstein bystander survival rate (58.5% v 52.5%, aOR = 0.79, 95% CI 0.6-0.97). Conclusion: In Texas during the COVID-19 pandemic, there was a greater number of OHCA events, with lower overall survival and increased prehospital TOR.