Key result
In-hospital mortality after sudden cardiac arrest was similar between patients with and without end-stage renal disease in a propensity-matched analysis (70.4% vs. 70.7%, p=0.45).
Why the study?
End-stage renal disease is a recognized risk factor for sudden cardiac arrest, but data on baseline characteristics and outcomes following in-hospital sudden cardiac arrest in this population were limited.
Does end-stage renal disease status affect in-hospital mortality in patients who sustain in-hospital sudden cardiac arrest?
Observational (n=1,412,985)
Yes
Does end-stage renal disease status affect in-hospital mortality in patients who sustain in-hospital sudden cardiac arrest?
Absolute Event Rate: 70.4% vs 70.7%
p-value: p=0.45
In-hospital mortality following sudden cardiac arrest is similarly high (>70%) in both ESRD and non-ESRD patients, despite ESRD patients being younger and having a higher baseline comorbidity burden.
Similar high mortality after in-hospital arrest irrespective of ESRD status should not yet change practice; leaves open whether ESRD-specific protocols warrant prospective testing.
Purpose: End stage renal disease (ESRD) is a well-recognized risk factor for development of sudden cardiac arrest (SCA). There is limited data on baseline characteristics and outcomes after an in-hospital SCA event in ESRD patients. Methods: For the purpose of this study, data were obtained from National Inpatient Sample from January 2007 to December 2017. In-hospital SCA was identified using International Classification of Disease, 9th Revision, Clinical Modification and International Classification of Disease, 10th Revision, Clinical Modification codes of 99.60, 99.63 and 5A12012. ESRD patients were subsequently identified using codes of 585.6 and N18.6. Baseline characteristics and outcomes were compared among ESRD and non-ESRD patients in crude and propensity matched (PS) cohorts. Predictors of mortality in ESRD patients after an in-hospital SCA event were analyzed using a multivariate logistic regression model. Results: A total of 1,412,985 patients sustained in-hospital SCA during our study period. ESRD patients with in-hospital SCA were younger and had a higher burden of key co-morbidities. Mortality was similar in ESRD and non-ESRD patients in PS matched cohort (70.4% vs. 70.7%, p = 0.45) with an overall downward trend over our study years. Advanced age, Black race and key co-morbidities independently predicted increased mortality while prior implantable defibrillator was associated with decreased mortality in ESRD patients after an in-hospital SCA event. Conclusion: In the context of in-hospital SCA, mortality is similar in ESRD and non-ESRD patients in adjusted analysis. Adequate risk factor modification could further mitigate the risk of in-hospital SCA among ESRD patients.
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Khan et al. (2021) conducted an observational in In-hospital sudden cardiac arrest (n=1,412,985). End-stage renal disease (ESRD) vs. Non-ESRD patients was evaluated on In-hospital mortality (propensity score matched) (p=0.45). In-hospital mortality after sudden cardiac arrest was similar between patients with and without end-stage renal disease in a propensity-matched analysis (70.4% vs. 70.7%, p=0.45).
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