• Resuscitation · Jan 2022

    Impact of the Three COVID-19 Surges in 2020 on In-Hospital Cardiac Arrest Survival in the United States.

    • Kashvi Gupta, Saket Girotra, Brahmajee K Nallamothu, Kevin Kennedy, Monique A Starks, Paul S Chan, and American Heart Association's Get With the Guidelines®-Resuscitation Investigators (listed in Supplementary Appendix).
    • Saint Luke's Mid America Heart Institute, Kansas City, MO, United States; Department of Internal Medicine, University of Missouri Kansas City, Kansas City, MO, United States; Michigan Integrated Center for Health Analytics and Medical Prediction (MiCHAMP), University of Michigan, Ann Arbor, MI, United States.
    • Resuscitation. 2022 Jan 1; 170: 134-140.

    BackgroundStudies have reported lower survival for in-hospital cardiac arrest (IHCA) during the initial COVID-19 surge. Whether the pandemic reduced IHCA survival during subsequent surges and in areas with lower COVID-19 rates is unknown.MethodsWithin Get-With-The-Guidelines®-Resuscitation, we identified 22,899 and 79,736 IHCAs during March to December in 2020 and 2015-2019, respectively. Using hierarchical regression, we compared risk-adjusted rates of survival to discharge in 2020 vs. 2015-19 during five COVID-19 periods: Surge 1 (March to mid-May), post-Surge 1 (mid-May to June), Surge 2 (July to mid-August), post-Surge 2 (mid-August to mid-October), and Surge 3 (mid-October to December). Monthly COVID-19 mortality rates for each hospital's county were categorized, per 1,000,000 residents, as very low (0-10), low (11-50), moderate (51-100), or high (>100).ResultsDuring each COVID-19 surge period in 2020, rates of survival to discharge for IHCA were lower, as compared with the same period in 2015-2019: Surge 1: adjusted OR: 0.81 (0.75-0.88); Surge 2: adjusted OR: 0.88 (0.79-0.97), Surge 3: adjusted OR: 0.79 (0.73-0.86). Lower survival was most pronounced at hospitals located in counties with moderate to high monthly COVID-19 mortality rates. In contrast, during the two post-surge periods, survival rates were similar in 2020 vs. 2015-2019: post-Surge 1: adjusted OR 0.93 (0.83-1.04) and post-Surge 2: adjusted OR 0.94 (0.86-1.03), even at hospitals with the highest county-level COVID-19 mortality rates.ConclusionsDuring the three COVID-19 surges in the U.S. during 2020, rates of survival to discharge for IHCA dropped substantially, especially in communities with moderate to high COVID-19 mortality rates.Copyright © 2021 Elsevier B.V. All rights reserved.

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