PO-03-222 CURRENT TRENDS AND OUTCOMES OF SUDDEN CARDIAC ARREST IN YOUNG ADULTS IN THE USA: INSIGHTS FROM THE NATIONAL INPATIENT SAMPLE

Abstract

Sudden cardiac arrest (SCA) is a rare but devastating event in young adults. There is a lack of population studies that evaluate the current trends and outcomes of SCA in young adults. We sought to estimate current trends in incidence, risk factors and mortality rates for out-of-hospital SCA in young adults (18 – 35 years) using the national in-patient sample of the USA. The demographic data of all young adults (18 – 35 years) admitted to hospitals in the US from 2016 to 2020 was analysed using the National Inpatient Sample database. We further identified primary admissions for sudden cardiac arrest using the ICD 10 code (I46). We analyzed the trend in the incidence and mortality of SCA during the study period using the marginal effect of years. Subsequently, we compared the sociodemographic and comorbid factors of patients with out-of-hospital SCA with other young adults admitted to the hospital. Multivariate logistic regression was then used to determine the sociodemographic and comorbid factors independently associated with SCA in our population. There were approximately 3,610 cases of out of hospital cardiac arrest in the study period, with an incidence rate of 1:10000 young adult admissions. The mean age at admission was (28.3 ± 0.4 years). We noted a 16.7% increase in SCA cases from 2016 to 2020 (660 to 770 cases). Similarly, there was a 21% increase in the mortality between 2016 and 2020 (474 to 574 deaths), with a mean mortality rate of 69.7% throughout the study period. The main factors associated with increased odds of SCA in young people were the presence of arrhythmias. Other significant risk factors were male sex, a history of stroke, electrolyte abnormalities, renal failure on hemodialysis, hypertrophic cardiomyopathy, congenital heart disease, and cocaine use disorder. There is an increase in the incidence of sudden cardiac arrest in young adults, with the main risk factors being male sex, history of stroke, hypertrophic cardiomyopathy, congenital heart disease, presence of arrhythmias and cocaine use disorder. Identifying young adults with high-risk characteristics as described above and implementing risk factor modification with aggressive surveillance can reduce the incidence of SCA and the risk of death in young adults.Tabled 1Sociodemographic and comorbid factors associated with Sudden Cardiac Arrest in Young AdultsVARIABLESOdds ratioLower limit of CIUpper limit of CIP-valueAGE1.000.981.020.373RACE (Reference, Whites)BlacksHispanicsAsians-1.070.621.25-0.850.450.78-1.360.842.01-0.5530.002*0.628Female0.410.330.51<0.001*Smoking0.760.571.030.077Dyslipidemia0.430.240.770.004*History of myocardial infarction0.730.182.960.663COPD1.270.572.840.558Stroke5.462.999.97<0.001*Hypertension0.750.561.010.057Hypothyroidism1.330.842.080.225Obesity0.920.691.240.593Arrhythmia27.5221.435.3<0.001*Electrolyte Derangement13.410.517.1<0.001*ESRD on Hemodialysis2.401.463.940.001*Oxygen Dependence1.170.363.790.792Hypertrophic cardiomyopathy7.893.0420.45<0.001*Cocaine Use Disorder1.761.202.570.004*Congenital heart disease2.941.725.03<0.001*∗Statistically significant findings, COPD - chronic obstructive pulmonary disease, CI - Confidence interval Open table in a new tab