Abstract: SA-PO1048
Racial Differences Among Recipients of Staff-Initiated CPR in Outpatient Dialysis Clinics
Session Information
- Hemodialysis and Frequent Dialysis - VI
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Hofacker, Samuel A., Duke University School of Medicine, Durham, North Carolina, United States
- Dupre, Matthew, Duke University School of Medicine, Durham, North Carolina, United States
- Vellano, Kimberly, Emory University, Atlanta, Georgia, United States
- Mcnally, Bryan, Emory University, Atlanta, Georgia, United States
- Svetkey, Laura P., Duke University School of Medicine, Durham, North Carolina, United States
- Pun, Patrick H., Duke University School of Medicine, Durham, North Carolina, United States
Background
Sudden cardiac arrest is the leading cause of death among hemodialysis patients. Despite practice guidelines recommending basic life support training for all hemodialysis clinic staff, rates of staff-initiated CPR are sub-optimal. Little is known about whether patient and clinic characteristics are associated with lower rates of dialysis staff-initiated CPR.
Methods
We examined data in the Cardiac Arrest Registry to Enhance Survival, a national surveillance registry with data submitted from 23 statewide registries and 70 additional communities, along with dialysis clinic data from the Centers for Medicare & Medicaid Services to identify cardiac arrests in outpatient hemodialysis clinics as well as characteristics of the rescue response between 2013 and 2017. Using multivariable logistic regression, we examined the likelihood of receiving dialysis staff-initiated CPR based on patient and dialysis clinic characteristics.
Results
Of the 1,581 patients who experienced cardiac arrest in hemodialysis clinics, 88.0% received staff-initiated CPR. 91.1% of White and 84.8% of Black patients received staff-initiated CPR (p=0.009). After accounting for patient age and sex, clinic characteristics, dialysis clinic neighborhood characteristics, and U.S. region (see Table), Black patients remained significantly less likely to receive staff-initiated CPR than White patients (aOR 0.45, 95% CI, 0.28 to 0.73). There was no relationship between patient race and dialysis staff automated external defibrillator application.
Conclusion
Black patients are significantly less likely than White patients to receive staff-initiated CPR during cardiac arrest in dialysis clinics across the US. Further understanding of resuscitation practices in dialysis clinics is necessary to address this finding.
Funding
- NIDDK Support