Trends in cardiac arrest mortality in the US, 1999-2020

Abstract Importance Cardiac arrest affects over 600,000 in the US. Despite large-scale public health and educational initiatives, survival rates are lower in certain racial and socioeconomic groups. Objective To examine the trends in annual rates of cardiac arrests mortality among adults stratified by age, race, and gender in the U.S. Design A county-level cross-sectional longitudinal study using death data from the Centres for Disease Control and Prevention’s (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) database from 1999 to 2020. Setting Using the multiple causes of death dataset from the CDC’s WONDER database, cardiac arrests were identified using the International Classification of Diseases (ICD), tenth revision, clinical modification codes. Participants Individuals aged 15 years or more whose death was attributed to cardiac arrest. Exposures Calendar year. Main outcomes and measures National trends in annual mortality from cardiac arrest in select demographic groups and at the state level. Results Between 1999 and 2020, the annual cardiac arrest related AAMR (CA-MR) declined through 2019 (132.9 to 89.7 per 100,000 residents, followed by an increase in 2020 (104.5 per 100,000). White patients constituted 82% of all deaths and 51% were female. The overall CA-MR during the study period was 104.48 per 100,000 persons. The CA-MR was higher for men as compared with women (123.5 vs. 89.7 per 100,000) and higher for Black as compared with White adults (154.4 vs. 99.1 per 100,000). Conclusion and relevance CA-MR in the overall population has declined, followed by an increase in 2020, which is likely the impact of COVID-19 pandemic. There were also significant racial and sex differences in mortality rates. Visual Abstract Visual representation of cardiac arrest-related mortality and the impact of social vulnerability index on mortality rates 42 Key Points Question What are the temporal trends on cardiac arrest-related deaths in the United States (U.S.)? Findings In this national cross-sectional study spanning 22 years, there was an overall declining trend in cardiac arrest mortality across all age groups, gender, race, and regions. However, in 2020 there was an increase in the rates of cardiac arrest mortality, likely due to the COVID-19 pandemic. There was also a state-level variation in cardiac arrest mortality, with certain states showing an increase in mortality rates. Meaning There was an overall reduction in the age-adjusted mortality rates due to cardiac arrest. This decrease in mortality rate was consistent across all genders, races, and US regions. There was also significant racial and sex differences in mortality rates.