Survival rates for out-of-hospital cardiac arrests in the United States have not fully recovered to pre-pandemic levels, according to a new study to be presented at the American Heart Association's Scientific Sessions 2024. The research, which analyzed data from over 500,000 adults who experienced out-of-hospital cardiac arrests between 2015 and 2022, reveals concerning trends in survival outcomes and persistent disparities affecting Black and Hispanic communities. The study found that before the COVID-19 pandemic, the overall survival-to-hospital discharge rate for out-of-hospital cardiac arrests was nearly 10%. However, this rate dropped to 9% in 2020 at the onset of the pandemic. While there has been a slight improvement to 9.1% in 2021 and 2022, survival rates remain significantly below pre-pandemic levels of 9.9%.
Notably, the research uncovered stark disparities in survival rates across different racial and ethnic communities. In predominantly Black and Hispanic communities, the survival rate declined to 6.6% in 2020, representing a relative decrease of 16.5% compared to pre-pandemic levels. This decrease was more pronounced than in multi-race integrated communities (-6.5%) or predominantly white communities (-8.1%). Dr. Eric Hall, the study's lead author and a cardiology fellow at UT Southwestern Medical Center, emphasized the significance of these findings: "Our results indicate that the onset of the COVID-19 pandemic largely erased gains in out-of-hospital cardiac arrest survival that had been achieved during the ten years before the pandemic, and it exacerbated disparities among Black and Hispanic communities."
The research team was surprised by the persistent lag in recovery. Dr. Saket Girotra, the study's senior author, noted, "We expected that survival after out-of-hospital cardiac arrest would have bounced back to levels before the pandemic. Even in 2022, survival rates remained worse than before the pandemic." Experts suggest that multiple factors may be contributing to the slow recovery in survival rates. Dr. Sarah Perman, chair of the American Heart Association's Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, pointed out that challenges in accessing healthcare and the impact of the opioid crisis, particularly the introduction of fentanyl into the illicit drug market, may be complicating factors.
The study also highlights the critical need for increased bystander CPR awareness and education. Dr. Perman emphasized the importance of community outreach and educational initiatives to improve cardiac arrest outcomes: "If someone who is in our circle unfortunately succumbs to a cardiac arrest, it's important to remember that you need to push hard and fast on the chest and call 911, so that you can activate emergency medical services to assist with the resuscitative efforts." These findings underscore the urgent need for targeted efforts to improve out-of-hospital cardiac arrest survival rates across all communities, with a particular focus on addressing disparities in Black and Hispanic populations. As the healthcare system continues to grapple with the long-term impacts of the COVID-19 pandemic, this research serves as a crucial reminder of the ongoing challenges in emergency cardiac care and the importance of community-wide preparedness and response.
