Abstract 430: Impact of the COVID-19 Pandemic on Out-of-Hospital Cardiac Arrest (OHCA) in Wayne County, Michigan

Abstract

Background: The COVID-19 pandemic has affected the incidence, presentation, care, and survival of OHCA. Early in the pandemic, healthcare systems were challenged by work force reduction due to illness and supply chain disruptions. We hypothesize there was an increase in the number of OHCA and a decrease in patient survival during the COVID-19 pandemic. Methods: We analyzed data from the Michigan Cardiac Arrest Registry to Enhance Survival (CARES) from 2018-2022 in Wayne County from two systems of care, Health Emergency Medical Services (HEMS) and Detroit East Medical Control Authority (DEMCA). We compared patient arrests and response characteristics during time periods: 2018-2019 (pre COVID-19), 2020-2021 (COVID-19), and 2022. Descriptive statistics were utilized for this retrospective review. Results: 40 EMS agencies are included, and 12,695 OHCA cases were identified. HEMS and DEMCA recorded a total of 2,262 OHCA in 2018 and 2,401 in 2019. OHCA increased to 2,797 in 2020, 2,652 in 2021, and to 2,583 in 2022. There was a 6.1% increase in OHCA from 2018 to 2019, and a 16.5% increase in 2020, with a decrease of 6.4% in both 2021 and 2022. This trend is similarly observed in the rate of asystole as presenting rhythm. In 2018 and 2019, an average of 46.8% of patients were pronounced in the emergency department (ED) or on scene. This average rose to 56.8% in 2020 and 2021 and was 47.9% in 2022. There was also a decline in the average percentage of patients surviving until hospital admission, 23.3% in 2018 and 2019 and decreased to 18.4% in 2020 and 2021, and 22.5% in 2022. ( Figure 1. ) Conclusion: The COVID-19 pandemic may have impacted pre-hospital mortality and morbidity. There was an increase in OHCA and asystole as a presenting rhythm. The percentage of patients pronounced in the ED or on scene also increased. This data demonstrates that as a region, we have not returned to pre-pandemic levels and survivability for OHCA. Figure 1. Comparison of OHCA EMS Runs from 2018-2022 in Wayne County, MI