Cardiac Arrest Survival Rates Lag Behind Pre-Pandemic Levels, Study Finds

A recent study presented at the American Heart Association's Scientific Sessions 2024 has revealed that out-of-hospital cardiac arrest survival rates in the United States have not fully rebounded to pre-pandemic levels. The research, which analyzed data from over half a million adults who experienced out-of-hospital cardiac arrests between 2015 and 2022, shows a significant drop in survival rates at the onset of the COVID-19 pandemic in 2020, with only slight improvements through 2022.

The study, led by Dr. Eric Hall, a cardiology fellow at UT Southwestern Medical Center in Dallas, found that before the pandemic, the overall survival-to-hospital discharge rate for out-of-hospital cardiac arrests was nearly 10%. However, this rate plummeted to 9% in 2020 and has only marginally improved to 9.1% in 2021 and 2022, still significantly below pre-pandemic levels.

Of particular concern are the disparities in survival rates among different racial and ethnic communities. The research indicates that predominantly Black and Hispanic communities experienced a more substantial decline in survival rates compared to predominantly white communities. In 2020, survival rates in Black and Hispanic communities fell to 6.6%, a relative decrease of 16.5% compared to pre-pandemic levels. While there has been some improvement in these communities since then, the gap in survival rates between Black and Hispanic communities and white communities persists.

Dr. Saket Girotra, the study's senior author, expressed surprise at the findings, noting that the team had expected survival rates to have returned to pre-pandemic levels by now. The researchers are conducting further studies to better understand the role of emergency medical services in cardiac arrest care and to identify best practices for treatment.

The study's findings have significant implications for public health and emergency medical services. They underscore the need for targeted efforts to improve cardiac arrest survival rates, particularly in Black and Hispanic communities. Dr. Sarah Perman, chair of the American Heart Association's Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, suggests that factors such as delayed healthcare-seeking behavior during the pandemic and challenges in accessing healthcare may be contributing to the slow recovery in survival rates.

Additionally, the study points to the potential impact of the opioid crisis on cardiac arrest survival rates. The introduction of fentanyl into the illicit drug market in 2019, coinciding with the onset of the pandemic, has led to an increase in overdose-associated cardiac arrests, further complicating the interpretation of the data.

The research highlights the critical importance of community education and outreach to increase awareness of cardiac arrest and improve CPR skills among the general public. As Dr. Perman emphasizes, knowing how to perform CPR and quickly activate emergency medical services can make a crucial difference in survival outcomes.

While the study has limitations, including its observational nature and the potential lack of applicability to communities not participating in the Cardiac Arrest Registry to Enhance Survival (CARES), it provides valuable insights into the ongoing challenges faced by emergency cardiac care systems in the wake of the COVID-19 pandemic.

As the medical community continues to grapple with the long-term effects of the pandemic on cardiac care, this research underscores the urgent need for renewed efforts to improve out-of-hospital cardiac arrest survival rates across all communities. It also serves as a call to action for policymakers and healthcare providers to address the persistent disparities in cardiac care outcomes among different racial and ethnic groups.