ICU cardiac evaluations increase survival odds for Black patients

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Although racial disparities in survival after in-hospital cardiac arrest among Black and white people persist, both groups had similar chances of receiving an intensive care unit (ICU) evaluation before a cardiac arrest. 

Receiving an ICU evaluation prior to cardiac arrest improved survival rates by 15% among Black people, according to preliminary research to be presented at the American Heart Association’s Resuscitation Science Symposium 2022. The 2022 meeting will be held in person in Chicago November 5-6, and will feature recent advances related to treating cardiopulmonary arrest and life-threatening traumatic injury.

For the study, researchers analyzed data for more than 28,000 adults, ages 18 years and older, who experienced cardiac arrest in a part of the hospital outside of the ICU between 2000 and 2021, from the American Heart Association Get With The Guidelines(R)-Resuscitation registry. Prior to having a cardiac arrest, all of the adults had been identified to be at risk for requiring more interventions to prevent it.

The study compared how often a specialized ICU evaluation was completed among Black individuals compared to white individuals. Additionally, researchers assessed if that ICU evaluation may have impacted survival among the Black patients. They did not conduct the same analysis on survival among white people, given research already establishing that survival after cardiac arrest is worse among Black adults compared to white adults.

Among all participants in the registry – average age of 68 years and 42% women – about 2,400 (9 out of every 100) received a specialized evaluation by the ICU team. Researchers found no difference in the frequency that the ICU team evaluated Black or white patients prior to cardiac arrest.

WHAT’S THE IMPACT

Lead author Dr. Cody Gathers, a critical care fellow in the pediatric intensive care unit at Children’s Hospital of Philadelphia, said it’s established that Black people have overall lower cardiac arrest survival rates compared to their white counterparts. Since there’s little difference in the rates at which ICU evaluations are being done, “it’s critical to further explore what else might drive these disparities in survival,” he said.

“And the medical community should continue to appropriately recognize patient needs and prioritize early ICU evaluation prior to cardiac arrest, especially since our results indicate these evaluations may improve survival significantly among Black adults,” he said.

The study’s findings are not generalizable to people from other diverse racial or ethnic groups, authors sad. In addition, the study’s findings are applicable only to the hospitals that participate in the database used for this study.

THE LARGER TREND

The American Hospital Association in March cited data showing that racial health inequities are associated with substantial annual economic losses nationally, including at least $10 billion in illness-related lost productivity and $200 billion in premature deaths.

According to the organization, eliminating health inequities also can lead to improved patient engagement in their care process and better health outcomes; decreased readmissions; and improved performance in value-based contracts through better care management, among other improvements.
 

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