Racial gap narrowing in survival for in-hospital cardiac arrest

A cohort study of more than 100,000 patients suffering in-hospital cardiac arrest showed greater survival gains among black patients than whites.

Published Aug. 9 in JAMA Cardiology, the study included data from 289 hospitals in the Get With the Guidelines-Resuscitation program. Researchers analyzed 112,139 patients with in-hospital cardiac arrest, 27 percent of them black and the rest white.

Risk-adjusted survival improved in black patients from 11.3 percent in 2000 to 21.4 percent in 2014. Over the same timeframe, white patients’ risk-adjusted survival rates grew from 15.8 percent to 23.2 percent.

Lead author Lee Joseph, MD, MS, of the Department of Internal Medicine at the University of Iowa, wrote the previous disparity was “largely attributable to the concentration of black patients in poor-quality hospitals.”

Joseph's research suggests all hospitals improved their quality of care, but hospitals with disproportionately black populations advanced the most.

“This is a triumph of modern American medicine, to improve survival from in-hospital cardiac arrest to this degree, this rapidly,” Myron Weisfeldt, MD, of the Johns Hopkins School of Medicine, said on a JAMA Cardiology podcast. “We’re using resources in a better way.”

One of those ways, Weisfeldt said, is the introduction of rapid-response teams (RRTs). RRTs feature health professionals from multiple disciplines who can quickly treat a patient or get the patient to the intensive care unit (ICU) before in-hospital cardiac arrest occurs.

Compared to other hospital units, ICUs are better equipped to handle cardiac arrests.

Weisfeldt noted the lack of a comprehensive national database on this topic, and said a larger data set is needed “so we can really know whether the very exciting results and important results of this study… is more broadly the case.”