Abstract 4140484: Socioeconomic Status and Outcomes of Patients with In-Hospital Cardiac Arrest

Background: Some studies illustrate an association between adverse outcomes and lower socioeconomic status (SES) in patients with cardiovascular disorders. Limited data exist on in-hospital cardiac arrest outcomes in the context of SES. Objectives: Using mean income as a surrogate for SES, we assessed the association of SES on outcomes and resource utilization for patients with in-hospital cardiac arrest. Methods: We queried the 2016-2019 Nationwide Inpatient Sample and identified inpatient cardiac arrest as the primary diagnosis. We compared in-hospital outcomes based on zip code mean income quartiles (≦2 (< $59,000) vs. ≧3). The primary outcome was inpatient mortality, while secondary outcomes included Palliative Care involvement, vasopressor use, mechanical ventilation use, targeted temperature control, mean length of stay (LOS), and total hospitalization cost (THC). Multivariable regression models were used to adjust for potential confounders. Results: Of 2,122,805 cases of in-hospital cardiac arrest, 1,146,314 (54%) involved patients with a lower income quartile. Lower quartiles were associated with higher odds of in-hospital mortality (adjusted OR [aOR] 1.08, 95% CI 1.05–1.11) and mechanical ventilation use (aOR 1.11, 95% CI 1.08-1.15), while they had lower odds of vasopressor use (aOR 0.62, 95% CI 0.55–0.71, p<0.001), Palliative Care involvement (aOR 0.95, 95% CI 0.92-0.99), and targeted temperature control (aOR 0.76, 95% CI 0.67-0.85), with less THC ($171,639 vs. $183,247, p <0.001) compared to patients in higher quartiles. Conclusion: In cases of in-hospital cardiac arrest, patients with lower income quartiles had higher mortality and less healthcare resource utilization compared to patients with higher income.