Abstract Details

Title Racial Differences In Hospital Utilization Of Therapeutic Hypothermia Among Cardiac Arrest Patients In United States

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-074

Objective We attempt to establish if race and ethnicity impact hospital utilization therapeutic hypothermia (TH) among cardiac arrest (CA) patients in the United States.

Background Racial/ethnic disparities exist in health care as it has been previously reported.

Design/Methods We identified our CA patient subset from NIS for years 2008-2014 using codes (DX1 = 427.5) and with a diagnosis or procedure code for TH (ICD-9 780.65, procedure code 99.81) from the International Classification of Diseases, 9th edition. Univariate analysis was performed to compare patients with CA treated with and without TH for age, gender, APRDRG (All Patient Refined Diagnosis Related Groups) severity length of stay (LOS), hospital characteristics (size, location, teaching status, and region) total hospital charges, inhospital mortality and discharge disability. In the multivariate analysis, patients who did not receive TH served as control group. We adjusted the analyses for age, gender, APRDRG severity scale, Insurance status, hospital bedsize, location/teaching status and median household income for patient's ZIP Code.

Results Of 984,403 patients with CA, 667,662 (67.8%), 167,052 (17.0%), 84,838 (8.6%) and 64,851 (6.6%) were White, Black, Hispanic and Others respectively. In univariate analysis the rate of utilization of TH among different races were as : Whites (3.32%), Blacks (3.43%), Hispanics (2.84%) and Others (3.98%).
In multivariate analysis the odds of receiving TH of different races against white race were as; Black (OR: 0.92, CI: 0.84 1.01) Hispanics (OR: 0.75 CI: 0.66 - 0.83) and Others (OR: 1.04, CI: 0.93- 1.18).
Higher odds of in-hospital mortality in all minority groups compared to their white counterparts
Higher odds of Institutional care in blacks compared to whites

Conclusions In our study, we found Hispanic had lower odds of receiving therapeutic hypothermia. Minorities had higher in-hospital mortality, and Blacks had higher institutional care as compared to white race. Further studies are encouraged to explore the possible reasons for these disparities

Authors/Disclosures
Mohammad Rauf A. Chaudhry, MD PRESENTER	Dr. Chaudhry has nothing to disclose.
	No disclosure on file
Ihtesham A. Qureshi, MD	No disclosure on file
Harathi Bandaru, MD	Dr. Bandaru has nothing to disclose.
Shayan Ul Haque, MD, MBBS	No disclosure on file
Michael A. Castellano, MD (UF Health Jacksonville)	No disclosure on file
	No disclosure on file
Rakesh Khatri, MD, FAAN	Dr. Khatri has received personal compensation in the range of $0-$499 for serving as a Survey consultant with Alpha insight . Dr. Khatri has received personal compensation in the range of $0-$499 for serving as a Survey consultant with Survey company .
Alberto Maud, MD (Paul L. Foster School of Medicine Texas Tech UHSC El Paso, Texas)	Dr. Maud has nothing to disclose.
Gustavo J. Rodriguez, MD (Gustavo J. Rodriguez)	Dr. Rodriguez has nothing to disclose.
Salvador Cruz-Flores, MD, FAAN (Paul L. Foster School of Medicine Texas Tech University Health Sciences Center)	The institution of Dr. Cruz-Flores has received research support from University of Texas System.

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