Among hospitalized atrial fibrillation patients, Black race was associated with 30% higher odds of in-hospital cardiac arrest (OR 1.30; 95% CI 1.13-1.50; p<0.001).
Observational (n=272,028)
Do race and household income impact the risk of cardiac arrest in hospitalized atrial fibrillation patients?
Black race and upper-middle household income are associated with a significantly higher risk of in-hospital cardiac arrest among patients admitted for atrial fibrillation.
Effect estimate: OR 1.30 (95% CI 1.13-1.50)
p-value: p=<0.001
Abstract Background An increasing association between atrial fibrillation (AF) and a higher risk of cardiac arrest is becoming evident. However, the role of race and household income in influencing the risk of cardiac arrest among hospitalized AF patients is still not well understood. Purpose The study aims to assess the impact of race and household income on cardiac arrest risk in hospitalized AF patients, with the goal of improving patient outcomes and reducing healthcare disparities. Methods Adult patients hospitalized between 2018 and 2020 with a primary diagnosis of AF were identified using the International Classification of Diseases, Tenth Revision (ICD 10) code. Patient demographics and comorbidities were recorded. Median household income was evaluated based on patient zip codes and categorized into quartiles: 0-25th percentile (Q1), 26th to 50th percentile (Q2), 51st to 75th percentile (Q3), and 76th to 100th percentile (Q4); the primary outcome was cardiac arrest during hospitalization. Unadjusted and adjusted analysis was performed on appropriate variables of interest. Results Out of 272,028 hospitalizations involving AF, 2,352 patients (median age: 69.5 years; interquartile range IQR: 56–82; 41% women) experienced cardiac arrest, with 523 in-hospital deaths recorded. The majority of patients were of white ethnicity. Notably, Black patients had 30% higher odds of cardiac arrest (odds ratio OR = 1.30, 95% confidence interval CI: 1.13–1.50, p 0.001). The second quartile (Q2) had the highest admission rate (73,606 patients). Additionally, patients in the upper-middle-income range (Q3) had a 17% increased risk of cardiac arrest (OR = 1.17, 95% CI: 1.03–1.33, p = 0.014). Conclusion Our study identifies disparities in cardiac arrest risk among hospitalized AF patients, with black race linked to higher odds of cardiac arrest. Interestingly, while patients in the Q2 range constituted the majority of admissions, those in the Q3 range showed an elevated risk of cardiac arrest. Addressing these disparities may be vital for improving patient outcomes.Figure 1 Figure 2
Brgdar et al. (2025) conducted an observational in Atrial fibrillation (n=272,028). Black race and household income vs. White race and other income quartiles was evaluated on Cardiac arrest during hospitalization (OR 1.30, 95% CI 1.13-1.50, p=<0.001). Among hospitalized atrial fibrillation patients, Black race was associated with 30% higher odds of in-hospital cardiac arrest (OR 1.30; 95% CI 1.13-1.50; p<0.001).