In-hospital cardiac arrest survival carries high readmission rates, price

Patients who survive in-hospital cardiac arrests are not completely out of the woods, and mortality, readmission rates and inpatient costs prove it. Researchers found that 30-day and one-year readmission rates were exceptionally high among in-hospital cardiac arrest survivors, as were inpatient costs.

Paul S. Chan, MD, MSc, from the Saint Luke’s Mid America Heart Institute in Kansas City, Mo., and colleagues examined linked patient data from the American Heart Association’s Get with the Guidelines: Resuscitation registry and Medicare inpatient files to come up with the basis for their analysis.

They found in-hospital cardiac arrest patients had cumulative incident rates of 35 readmissions per 100 patients during the first 30 days and 185 readmissions per 100 patients at one year. Patients had mean inpatient costs of around $7,741 at 30-days and $18,629 in the first year. The research team noted readmission for in-hospital cardiac arrest rates and costs were similar to those seen in patients with significant stroke disability and decompensated heart failure.

One third of all readmissions reported listed cardiovascular disease as the reason, they noted.

A subanalysis showed certain groups bore more burden of inpatient costs and readmission rates that persisted through one year. Some resource-use difference related to the degree of disability experienced by the patient at discharge or where they were being discharged to, with the greater expense resting with patients experiencing severe neurological disability or being discharged to skilled nursing facilities. However, those weren’t the only variables that increased cost.

They found that younger patients racked up the highest inpatient costs by age. Patients between 65 and 74 years old had 30-day inpatient costs around $8,291on average, $2,241 more than patients 85 years or older.

Black patients incurred higher costs than white patients, with 30-day inpatient costs of $9,044 vs. $7,413, respectively.

Chan et al wrote that the data they provided should allow future analyses of emerging treatment strategies to determine precise cost effectiveness in assisting patients with in-hospital cardiac arrests.

This study was published online Oct. 28 in Circulation: Cardiovascular Quality and Outcomes.