Abstract 18793: Demographic and Regional Trends in Mortality From Cardiac Arrest in the USA From 1999-2020

Abstract

Introduction: Cardiac Arrest (CA) is a major public health problem associated with high mortality. We aim to assess the demographic and racial trends of mortality associated with CA between 1999 and 2020. Methods: A cross-sectional analysis of the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiological Research database (CDC-WONDER) was conducted to investigate the trends in mortality associated with CA (ICD codes -I46.0, I46, I46.9, and I49.0). Using Joinpoint regression analysis, the study calculated age-adjusted mortality rates (AAMR) per 1,000,000 individuals and corresponding annual percentage changes (APC), along with 95% confidence intervals. Demographic and racial trends were evaluated. Results: 394,021 CA-related deaths occurred from 1999 to 2020. Annual trends show that the AAMR reduced from 8.3 (95% CI 8.2-8.4) in 1999 to 4.7(95% CI 4.6-4.8) in 2020. The overall AAMR from 1999-2018 had an Annual Percentage Change (APC) decrease of -2.0 (95% CI: -2.4 to -1.6). From 2012 to 2020, the APC was 0.4(95% CI: -0.3 to 1). When stratified by sex, males had a worse AAMR at 6.4 (95% CI: 6.4-6.4), and women were found to have an AAMR of 4.5 (95% CI: 4.4-4.5). When stratified by ethnicity, AAMR was highest among African Americans at 9.3 (95% CI: 9.2-9.3), followed by White at 5.0 (95% CI 5.0-5.0), followed by Asian or Pacific Islanders at 3.6(95% CI 3.5-3.7) and American Indian or Alaska Native patients at 3.0 (95% CI2.9-3.2). When stratified by geographical area, Non-metro, rural areas had worse AAMR than urban areas. Conclusions: There has been a general decrease in CA-associated mortality from 1999 to 2012 in the United States. However, since 2012, the mortality has been stable and not improving. Our data shows that the AAMR is worse in men, African Americans, and rural populations. In the setting of no improvement of AAMR since 2012, further research is needed to identify the causes and potential strategies to improve AAMR.