Baseline Characteristics and Outcomes of End-Stage Renal Disease
Patients after In-hospital Sudden Cardiac Arrest: A National Perspective
Abstract
Background: End stage renal disease (ESRD) is a well-recognized risk
factor for development of sudden cardiac arrest (SCA). There is limited
data on baseline characteristics and outcomes after an in-hospital SCA
event in ESRD patients. Methods: For the purpose of this study, data
were obtained from National Inpatient Sample from January 2007 to
December 2017. In-hospital SCA was identified using International
Classification of Disease, 9th Revision, Clinical Modification and
International Classification of Disease, 10th Revision, Clinical
Modification codes of 99.60, 99.63 and 5A12012. ESRD patients were
subsequently identified using codes of 585.6 and N18.6. Baseline
characteristics and outcomes were compared among ESRD and non-ESRD
patients in crude and propensity matched (PS) cohorts. Predictors of
mortality in ESRD patients after an in-hospital SCA event were analyzed
using a multivariate logistic regression model. Results: A total of
1,412,985 patients sustained in-hospital SCA during our study period.
ESRD patients with in-hospital SCA were younger and had a higher burden
of key co-morbidities. Mortality was similar in ESRD and non-ESRD
patients in PS matched cohort (70.4% vs. 70.7%, p = 0.45) with an
overall downward trend over our study years. Advanced age, Black race,
diabetes, hypertension and peripheral vascular disease were
independently associated with increased mortality in ESRD patients after
an in-hospital SCA event. Conclusion: In the context of in-hospital SCA,
mortality is similar in ESRD and non-ESRD patients in adjusted analysis.
Adequate risk factor modification could further mitigate the risk of
in-hospital SCA among ESRD patients.