Race is not associated with medical emergency team evaluation prior to in-hospital cardiac arrest

Abstract

Background: Black patients have worse outcomes after in-hospital cardiac arrest (IHCA). Whether these racial disparities are associated with medical emergency team (MET) evaluation prior to IHCA remains unknown.

Methods: A retrospective cohort study of adults age ≥ 18 years from the American Heart Association Get With The Guidelines® Resuscitation registry who had an IHCA between 2000 and 2021 with acute physiologic decline (modified early warning score [MEWS] ≥ 3) during the 24 h prior to IHCA. A propensity-weighted cohort was constructed to balance confounders between Black and White patients. The association between race and MET evaluation was quantified with weighted multivariable logistic regression.

Results: Among 354,480 patients, 88,507 met the initial inclusion criteria, of which 29,714 patients (median age 69 [IQR 58-79] years, 42.5% female, and 26.9% Black) had acute physiologic decline during the 24 h prior to IHCA. Among patients with acute physiologic decline, 4102 (13.8%) patients had a preceding MET evaluation before IHCA. Rates of MET evaluation prior to cardiac arrest did not differ significantly between Black and White patients with acute physiologic decline (aOR 1.02, 95% CI 0.94-1.11, p = 0.62).

Conclusions: Though racial disparities in IHCA outcomes exist, this study did not detect a difference in rates of MET evaluation prior to IHCA among patients with acute physiologic decline as a potential mechanism for these disparities.

Keywords: Cardiac arrest; Health equity; Medical emergency team.