Abstract 13753: Higher Social Vulnerability Index is Associated With Increased Mortality Following Cardiac Arrest

Introduction: Cardiac arrest(CA) is a strong predictor of death. Survival following CA depends on timely initiation of quality cardiopulmonary resuscitation (CPR) and post CA care. The availability of competent individuals, resources and necessary services may be greatly influenced by the characteristics of the communities in which the indexed CA occurs. The Social Vulnerability Index(SVI) is a robust index which reliably ranks counties based on diverse parameters on a scale from 0 to 1. The higher the SVI, the more disadvantaged the community is. Hypothesis: We hypothesize that there is a positive correlation between CA related AAMR( expressed per 100,000 persons) and SVI in the USA. Methods: Using the multiple causes of death database from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research(1999-2020), we extracted county level deaths with any mention of CA with ICD-10 codes I46.0, I46.1, I46.9. County level SVI was obtained from CDC/ATSDR. SVI was stratified into quintiles. We fitted segmented regression models to evaluate the association between quintiles of SVI scores and CA-related age-adjusted mortality rate (AAMR, expressed per 100,000 persons). Analysis was done using STATA v17 and Joinpoint segmented regression softwares with p-values <0.05 considered statistically significant. Results: The CA related AAMR was 104.5 per 100,000 (95% CI 104.4 - 104.6) for the entire USA, decreasing from 132.9 (132.4 - 133.3) in 1999 to 104.5 (104.2 - 104.8) in 2020. We observed a monotonous increase in AAMR with increasing SVI as shown on figure 1 with an average quintile percentage change of 20.8% (95% CI 13.1 - 29.0) with a p-value of 0.003. Conclusions: Persons who suffer cardiac arrest in counties with higher SVI are more likely to die compared to those who suffer CA in counties with lower SVI. Further research is needed to identify and address the driving factors so as to reduce existing disparity. .