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The National Institutes of Health and the American Heart Association annually report the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors. The American Heart Association’s latest report, Heart and Stroke Statistics – 2022 Update, highlighted that cardiac arrest remains a public health crisis.

Report Highlights

Regardless of being a leading cause of death, there are no standards for monitoring the incidence and outcomes of cardiac arrest. Thus, registries and clinical trials provide the best estimates, such as the Resuscitation Outcomes Consortium (ROC), 2005-2015, and the ongoing Cardiac Arrest Registry to Enhance Survival (CARES).

• There are more than 356,000 out-of-hospital cardiac arrests (OHCA) in the United States each year, about 90% fatal.
• EMS-assessed non-traumatic OHCA in people of any age is estimated to be 356,461, or about 1,000 people a day. Survival to hospital discharge after EMS-treated cardiac arrest drops to roughly 10%.
• Based on CARES data from 2021, the location of adult out-of-hospital cardiac arrests was most often a home (73.9%), followed by public settings (15.1%) and nursing homes (10.9%). For children, most often was at home (87.5%), followed by a public place (12.2%)

Effects of the Pandemic

• Studies also show that the COVID pandemic had multiple effects on the incidence of out-of-hospital cardiac arrests. In New York City, between March 1-April 25, 2020, the incidence of OHCA attended by EMS tripled compared with the same period in 2019. 
• CARES registry data shows increased delays to initiation of CPR for OHCA and reduced survival overlapping with the time of the pandemic. There was a decline in the frequency of shockable rhythms, incidences happening in public locations, and bystanders’ AED use. Despite this, there was no substantial alteration in the commonness of bystander CPR.

CPR and AED Awareness

• In a survey containing 9,022 people, 18% reported having CPR training, and 65% had CPR training at some point. CPR training was lower in Hispanics/Latinos, the elderly, people with less formal education, and lower-income groups.
• According to CARES 2020 data, bystanders performed CPR in 40.8% of OCHAs. States with the highest bystander CPR rates include:
  • Alaska (72%)
  • Washington (56.3%)
  • Oregon (56%)
  • Vermont (53.8%)
• Bystanders were less likely to initiate CPR in low-income Black or predominately Hispanic neighborhoods than in high-income White neighborhoods.
• Bystanders used AEDs in 5.8% of OHCAs and provided a shock in 1.3% of OHCAs.
  
• In 2020, an AED in 9% of cases. States with the highest rates of bystander AED use include
  • Nebraska – 16.3%
  • Oregon – 13.5%
  • Washington – 10.9%
  • Pennsylvania – 10.3%
    

Recovery

• Cardiac arrest survivors experience multiple medical problems, including impaired consciousness and cognitive deficits.
• Recovery continues for at least the first 12 months in children and 6 to 12 months after OHCA in adults.
• One hundred forty-one people who survived hospitalization after SCA suffered the following:
  • Severe fatigue – 52%
  • Post-traumatic stress symptoms – 28%
  • Anxiety and depression – 15%
  • Severe cognitive deficits – 13%
• Subjective symptoms declined over time, although 10-22% had cognitive impairments after 12 months.
• 72% of those individuals returned to work after 12 months.
• Among 195 caregivers of survivors, 25% experienced anxiety, and 14% experienced depression.

 Sources

• AHA Journals. “Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association.” https://www.ahajournals.org. 25 March 2022.

Last updated Jan 10, 2023

January 12, 2023