Abstract
Introduction: Cardiac arrest(CA) is a strong predictor of death. Survival following CA depends on timely initiation of quality cardiopulmonary resuscitation and post CA care. Significant efforts have been made in the training of individuals at delivering CPR and improving post CA aimed at reducing mortality. To assess the impact, we set out to determine the trends in age adjusted mortality rates(AAMR, per 100,000 persons) and the average annual percentage change (AAPC, %) in the USA and by gender, race and Metro area from 1999 - 2020. Methods: Using the underlying causes of death (UCOD) database from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research(1999-2020), we extracted all deaths with CA as UCOD using ICD-10 codes I46.0, I46.1, I46.9. AAMR was assessed using segmented regression models. STATA and Joinpoint softwares were used for analysis. Results: The CA related AAMR was 4.9 during the period 1999-2020. CA related deaths steadily declined from 7.7 in 1999 to 4.4 in 2020 with a statistically significant AAPC of -2.4%(95% CI -4.2 to -0.6). Ethnic specific AAMR were 8.7, 4.9, 2.8 and 3.4 for African Americans(AA), Whites, American Indian or Alaska Native and Asian or Pacific Islander, respectively. But for AA with an AAPC of -1.8%(CI -3.5 to 0.0), all other ethnic groups witnessed statistically significant decline in AAMR. AAMR were 5.3 and 5.5 for women and men, respectively. The AAPC were -2.7%(-4.5 to -0.8) and -2.5(-3.6 to -1.3) for women and men, respectively. The AAMR were 3.5, 5.6 and 8.1 for Large, Medium and Non-Metro areas, respectively, which all showed statistically significant decline. Conclusions: There has been a statistically significant decline in CA related AAMR in the USA from 1999-2020. Though AA harbor the highest AAMR, there has been no significant change in AAMR in the past two decades. Reasons for these racial disparities need to be investigated and addressed.
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