Abstract 10: Association Of Race And Medical Emergency Team Evaluations Prior To In Hospital Cardiac Arrest

Introduction: Racial disparities for in-hospital cardiac arrest (IHCA) outcomes exist. However, whether these are associated with medical emergency team (MET) activation prior to IHCA remain unknown. We aimed to evaluate the association between race and MET activation among patients with physiologic abnormalities (modified early warning score [MEWS] ≥3) prior to IHCA. We hypothesized that MET activation prior to IHCA would be less likely among Black as compared to white patients. In a secondary analysis, we hypothesized that among Black patients, MET activation would be associated with improved IHCA outcomes compared to events without MET activation. Methods: Retrospective cohort study of adults age ≥18 from the AHA Get With The Guidelines®-Resuscitation registry who had an IHCA outside an ICU between 2000 and 2021 with MEWS ≥3 prior to IHCA. A propensity-weighted cohort was constructed to balance confounders between Black and white patients. The association between race (Black vs. white) and MET activation (yes/no) was quantified with weighted multivariable logistic regression. A secondary analysis examined the association between any MET activation and IHCA outcomes among all Black patients. Results: Among 28,123 patients (average age: 68±15; 42% (42 of 100) female) with MEWS ≥3 (average 4±1), 2431 (9% (9 of 100)) had a documented MET activation prior to IHCA. Vitals were measured at a median time of 120 minutes (IQR 60, 210) prior to IHCA. Rates of MET activation were similar between Black and white patients with MEWS ≥3 prior to IHCA (aOR 1.04, CI 0.94-1.15, p=0.45). However, among Black patients, odds of ROSC were higher among patients with a MET activation prior to ICHA compared to those who did not have a MET activation (aOR 1.15, CI 1.03-1.28, p=0.02). Conclusions: Though racial disparities in IHCA outcomes exist, we failed to detect a significant association between race and MET activation for MEWS ≥3 as a potential mechanism for these disparities. Importantly, any MET activation improved IHCA outcomes among Black patients.