Abstract 13150: Racial/Ethnic Disparities of the Impact of the COVID-19 Pandemic Out-of-Hospital Cardiac Arrest (OHCA) in Texas

Introduction: Prior research shows a greater disease burden, lower BCPR rates, and worse outcomes in Black and Hispanic patients after OHCA. The CDC has declared that the COVID-19 pandemic has disproportionately affected many racial and ethnic minority groups. However, the influence of the COVID-19 pandemic on OHCA incidence and outcomes in different races and ethnicities is unknown. Purpose: To describe racial/ethnic disparities in OHCA incidence, processes of care and outcomes in Texas during the COVID-19 pandemic. Methods: We used data from the Texas Cardiac Arrest Registry to Enhance Survival (CARES) comparing adult OHCA from the pre-pandemic period (March 11 - December 31, 2019) to the pandemic period (March 11- December 31, 2020). The racial and ethnic categories were White, Black, Hispanic or Other. Outcomes were rates of BCPR, AED use, sustained ROSC, prehospital termination of resuscitation (TOR), survival to hospital admission, survival to discharge and good neurological outcomes. We fit a mixed effect logistic regression model, with EMS agency designated as the random intercept to obtain aORs. We adjusted for the pandemic and other covariates. Results: A total of 8,070 OHCAs were included. The proportion of cardiac arrests increased for Blacks (903 to 1, 113, 24.9% to 25.5%) and Hispanics (935 to 1,221, 25.8% to 27.5%) and decreased for Whites (1 595 to 1,869, 44.0% to 42.1%) and Other (194 to 220, 5.4% to 5.0%) patients. Compared to Whites, Black (aOR = 0.73, 95% CI 0.65-0.82) and Hispanic patients (aOR = 0.78, 95% CI 0.68-0.87) were less likely to receive BCPR. Compared to Whites, Blacks were less likely to have sustained ROSC (aOR = 0.81, 95% CI 0.70-0.93%), with lower rates of survival to hospital admission (aOR = 0.87, 95% CI 0.75-1.0), and worse neurological outcomes (aOR = 0.45, 95% 0.28-0.73). Hispanics were less likely to have prehospital TOR compared to Whites (aOR = 0.86, 95% CI = 0.75-0.99). The Utstein bystander survival rate was worse for Blacks (aOR = 0.72, 95% CI 0.54-0.97) and Hispanics (aOR = 0.71, 95% 0.53-0.95) compared to Whites. Conclusion: Racial and ethnic disparities persisted during the COVID-19 pandemic in Texas.

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Race/ethnicity in systemic AL amyloidosis: perspectives on disease and outcome disparities

Blood Cancer Journal ◽

10.1038/s41408-020-00385-0 ◽

2020 ◽

Vol 10 (11) ◽

Author(s):

Andrew Staron ◽

Lawreen H. Connors ◽

Luke Zheng ◽

Gheorghe Doros ◽

Vaishali Sanchorawala

Keyword(s):

Minority Groups ◽

Ethnic Disparities ◽

Sociodemographic Factors ◽

Al Amyloidosis ◽

Advocacy Groups ◽

Disease Characteristics ◽

Race Ethnicity ◽

The Impact ◽

Racial Ethnic ◽

Hispanic White

Abstract In marked contrast to multiple myeloma, racial/ethnic minorities are underrepresented in publications of systemic light-chain (AL) amyloidosis. The impact of race/ethnicity is therefore lacking in the narrative of this disease. To address this gap, we compared disease characteristics, treatments, and outcomes across racial/ethnic groups in a referred cohort of patients with AL amyloidosis from 1990 to 2020. Among 2416 patients, 14% were minorities. Non-Hispanic Blacks (NHBs) comprised 8% and had higher-risk sociodemographic factors. Hispanics comprised 4% and presented with disproportionately more BU stage IIIb cardiac involvement (27% vs. 4–17%). At onset, minority groups were younger in age by 4–6 years. There was indication of more aggressive disease phenotype among NHBs with higher prevalence of difference between involved and uninvolved free light chains >180 mg/L (39% vs. 22–33%, P = 0.044). Receipt of stem cell transplantation was 30% lower in Hispanics compared to non-Hispanic White (NHWs) on account of sociodemographic and physiologic factors. Although the age/sex-adjusted hazard for death among NHBs was 24% higher relative to NHWs (P = 0.020), race/ethnicity itself did not impact survival after controlling for disease severity and treatment variables. These findings highlight the complexities of racial/ethnic disparities in AL amyloidosis. Directed efforts by providers and advocacy groups are needed to expand access to testing and effective treatments within underprivileged communities.

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Abstract 13193: Hispanics/Latinos Lack Access to Hospitals With Therapeutic Hypothermia Programs Following Out-of-Hospital Cardiac Arrest

Circulation ◽

10.1161/circ.144.suppl_2.13193 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Nicholas Morris ◽

Michael Mazzeffi ◽

Patrick McArdle ◽

Teresa May ◽

Greer Waldrop ◽

...

Keyword(s):

Cardiac Arrest ◽

Hospital Admission ◽

Therapeutic Hypothermia ◽

Secondary Analysis ◽

Ethnic Disparities ◽

The United States ◽

Black Patients ◽

To Receive ◽

Racial Ethnic ◽

Hospital Cardiac Arrest

Introduction: Variation exists in outcomes following out-of-hospital cardiac arrest (OHCA), but whether racial/ethnic disparities exist in post-arrest provision of therapeutic hypothermia (TH) is unknown. Hypothesis: Racial/ethnic disparities exist in the utilization of guideline-recommended TH following OHCA. Methods: We performed a retrospective analysis of a cohort of 96,695 patients who survived to hospital admission following OHCA from the Cardiac Arrest Registry to Enhance Survival, whose catchment area represents ~40% of the United States, from 2013 through 2019. Our primary exposure was race/ethnicity, and the primary outcome was utilization of TH. We performed a secondary analysis to assess for racial/ethnic disparities in the reasons why TH was not used (supplemental data element data available since 2016). Results: Among 96,695 patients [mean (SD) age 61.4 (16.3) years, 24.6% Black, 8.0% Hispanic/Latino, 63.4% White] that survived to hospital admission following OHCA, 54,687 (56.6%) did not receive TH. Using a mixed-effects model that adjusted for patient, arrest, neighborhood, and hospital factors with state of arrest modeled as a random intercept to account for clustering, we found that Hispanics/Latinos were less likely to receive TH than Whites (Odds Ratio [OR] 0.79, 95 % Confidence Interval [CI] 0.75-0.83). When the clustering variable was changed from the state of arrest to the admitting hospital, Hispanics/Latinos were more likely to receive TH (OR 1.07, 95% CI 1.00 to 1.14). In the 22,896 patients with data regarding why they did not receive TH, a higher percentage of Hispanics/Latinos compared to Blacks and Whites did not receive TH due to lack of a TH program at the hospital (4.0% vs. 2.5 % vs 1.8%, p < .001). No disparity in TH utilization was found for Black patients. Conclusion: We found disparities in access to TH for Hispanics/Latinos following OHCA. Reassuringly, we did not find any disparity in TH utilization for Black patients.

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Abstract 10707: The Impact of the COVID-19 Pandemic on Incidence and Outcomes from Out-of-Hospital Cardiac Arrest (OHCA) in Texas

Circulation ◽

10.1161/circ.144.suppl_2.10707 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Summer Chavez ◽

Ryan Huebinger ◽

Joseph Gill ◽

Lynn White ◽

Hei Kit Chan ◽

...

Keyword(s):

Cardiac Arrest ◽

Hospital Discharge ◽

Healthcare Facilities ◽

Neurological Outcomes ◽

Random Intercept ◽

Initial Rhythm ◽

Race Ethnicity ◽

Location Type ◽

The Impact ◽

Hospital Cardiac Arrest

Introduction: Nationally, the COVID-19 pandemic was associated with worse OHCA outcomes. Whether these trends persist or were consistent between states is unclear. Purpose: To determine the impact of COVID-19 on OHCA incidence and outcomes in Texas between 2019-2020. Methods: We analyzed adult OHCAs in Texas from the Cardiac Arrest Registry to Enhance Survival (CARES) during a matched period (March 11-December 31 from 2019 through 2020). We excluded cases witnessed by 9-1-1 responders and arrests occurring at healthcare facilities. Outcomes were rates of BCPR, AED use, sustained ROSC, prehospital termination of resuscitation (TOR), survival to hospital, survival to hospital discharge, good neurological outcomes and Utstein bystander survival. We created a mixed effects logistic regression model analyzing the effect of the pandemic on outcomes, using EMS agency as the random intercept. We adjusted for age, gender, race/ethnicity, witnessed arrest, initial rhythm type and location type. Results: There were 8,070 OHCA cases, with 4,443 (55.1%) in the pandemic period (March 11 - December 31, 2020) and 3,627 (44.5%) from March 11 - December 31 2019, a relative 18.4% increase. There was a significantly decreased odds of BCPR (46.2% v 42.2%, aOR = 0.87, 95% CI 0.79-0.95), AED use (13.0% v 7.3%, aOR = 0.53, 95% CI 0.36-0.78), and sustained ROSC (28.8% v 21.2%, aOR = 0.67, 95% CI 0.60-0.74) during the pandemic. Survival to hospital (27.1% v 20.9%, aOR = 0.72, 95% CI 0.65-0.80) and survival to hospital discharge (10.0% v 7.4%, aOR = 0.71, 95% CI 0.64-0.89) also decreased. Prehospital TOR increased (37.3% v 46.7%, aOR = 1.51, 95% CI 1.35-1.67). The pandemic was associated with a lower Utstein bystander survival rate (58.5% v 52.5%, aOR = 0.79, 95% CI 0.6-0.97). Conclusion: In Texas during the COVID-19 pandemic, there was a greater number of OHCA events, with lower overall survival and increased prehospital TOR.

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Demographics associated with US healthcare disparities are exacerbated by the telemedicine surge during the COVID-19 pandemic

Journal of Telemedicine and Telecare ◽

10.1177/1357633x211025939 ◽

2021 ◽

pp. 1357633X2110259

Author(s):

Kristin N Gmunder ◽

Jose W Ruiz ◽

Dido Franceschi ◽

Maritza M Suarez

Keyword(s):

Income Tax ◽

Healthcare Disparities ◽

Descriptive Statistics ◽

Internal Revenue Service ◽

Patient Specific ◽

Postal Code ◽

The Us ◽

Hispanic Patients ◽

The Impact ◽

Racial Ethnic

Introduction As coronavirus disease 2019 (COVID-19) hit the US, there was widespread and urgent implementation of telemedicine programs nationwide without much focus on the impact on patient populations with known existing healthcare disparities. To better understand which populations cannot access telemedicine during the coronavirus disease 2019 pandemic, this study aims to demographically describe and identify the most important demographic predictors of telemedicine visit completion in an urban health system. Methods Patient de-identified demographics and telemedicine visit data ( N = 362,764) between March 1, 2020 and October 31, 2020 were combined with Internal Revenue Service 2018 individual income tax data by postal code. Descriptive statistics and mixed effects logistic regression were used to determine impactful patient predictors of telemedicine completion, while adjusting for clustering at the clinical site level. Results Many patient-specific demographics were found to be significant. Descriptive statistics showed older patients had lower rates of completion ( p < 0.001). Also, Hispanic patients had statistically significant lower rates ( p < 0.001). Overall, minorities (racial, ethnic, and language) had decreased odds ratios of successful telemedicine completion compared to the reference. Discussion While telemedicine use continues to be critical during the coronavirus disease 2019 pandemic, entire populations struggle with access—possibly widening existing disparities. These results contribute large datasets with significant findings to the limited research on telemedicine access and can help guide us in improving telemedicine disparities across our health systems and on a wider scale.

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Reductions in US life expectancy from COVID-19 by Race and Ethnicity: Is 2021 a repetition of 2020?

10.1101/2021.10.17.21265117 ◽

2021 ◽

Author(s):

Theresa Andrasfay ◽

Noreen Goldman

Keyword(s):

Life Expectancy ◽

Race And Ethnicity ◽

Ethnic Disparities ◽

White Population ◽

Widespread Distribution ◽

Life Expectancy At Birth ◽

The Us ◽

The Impact ◽

Racial Ethnic ◽

Black And Latino

COVID-19 had a huge mortality impact in the US in 2020 and accounted for the majority of the 1.5-year reduction in 2020 life expectancy at birth. There were also substantial racial/ethnic disparities in the mortality impact of COVID-19 in 2020, with the Black and Latino populations experiencing reductions in life expectancy at birth over twice the reduction experienced by the White population. Despite continued vulnerability of the Black and Latino populations, the hope was that widespread distribution of effective vaccines would mitigate the overall impact and reduce racial/ethnic disparities in 2021. In this study, we use cause-deleted life table methods to estimate the impact of COVID-19 mortality on 2021 US period life expectancy. Our partial-year estimates, based on provisional COVID-19 deaths for January-early October 2021 suggest that racial/ethnic disparities have persisted and that life expectancy at birth in 2021 has already declined by 1.2 years from pre-pandemic levels. Our projected full-year estimates, based on projections of COVID-19 deaths through the end of 2021 from the Institute for Health Metrics and Evaluation, suggest a 1.8-year reduction in US life expectancy at birth from pre-pandemic levels, a steeper decline than the estimates produced for 2020. The reductions in life expectancy at birth estimated for the Black and Latino populations are 1.6-2.4 times the impact for the White population.

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Women of Ethnic Minorities in Pediatrics

PEDIATRICS ◽

10.1542/peds.71.4.706 ◽

1983 ◽

Vol 71 (4) ◽

pp. 706-710

Keyword(s):

Civil Rights ◽

Mexican American ◽

Minority Groups ◽

Medical Schools ◽

Ethnic Origin ◽

Minority Women ◽

Minority Men ◽

Many Sources ◽

The Impact ◽

Racial Ethnic

OVERVIEW Minority women physicians may be defined as those of nonwhite racial and ethnic identification. There is a paucity of data available on these women. Until the passage of the 1964 Civil Rights Act and the impact of affirmative action programs, reliable statistics regarding minorities were scarce. Subsequently, a data base identifying racial/ethnic origin as well as sex of medical students and physicians has been evolving. Many sources are currently unable to provide such information because most applications are without racial identification. Neither the American Board of Pediatrics (ABP) nor the American Academy of Pediatrics (AAP) maintain data regarding racial/ethnic origin of members. In the 1970s there was a rapid increase in admissions of both women and minorities in US medical schools. First-year enrollment in 1980-1981 included 14.1% minority men and women (Table 1). The number of minority women entering medical school increased from 266 (2.2%) in 1971-1972 to 1,066 (6.2%) in 1981-1982 (Table 2). In departments of pediatrics in US medical schools in 1982, minority women represented 17% of all faculty members. Of 201 minority women, there were 127 Asian, 37 black, 24 Puerto Rican, three Mexican-American, nine other Hispanic, and one American Indian. The most significant increase in representation has occurred in the Asian ethnic group. Minority populations have poorer health status and are at higher risk with respect to accessibility, availability, and utilization of health services. The recruitment and training of minority physicians is important in providing culturally sensitive health care acceptable to bilingual and bicultural minorities. Most minority groups have career development problems that may be related to their ethnic and cultural background.

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Abstract 312: The Impact of Sedation on Quantitative Electroencephalogram Trends and Neurological Outcomes in a Mouse Model of Cardiac Arrest and Cardiopulmonary Resuscitation

Circulation ◽

10.1161/circ.142.suppl_4.312 ◽

2020 ◽

Vol 142 (Suppl_4) ◽

Author(s):

Takamitsu Ikeda ◽

Yusuke Miyazaki ◽

Eizo Marutani ◽

Fumito Ichinose

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Neurological Function ◽

Temperature Management ◽

Vehicle Group ◽

Altered Level ◽

Eeg Activity ◽

Neurological Outcomes ◽

Significant Difference ◽

The Impact

Introduction: The majority of patients resuscitated from cardiac arrest (CA) present in coma or with an altered level of consciousness. Although most CA survivors are sedated during targeted temperature management, the effects of sedation on post-arrest outcomes remain to be determined. Hypothesis: Sedation after CA improves neurological outcomes by modulating cerebral electrical activity and metabolism. Methods: Ten to 14 days after implantation of EEG transmitters, adult male C57BL/6J mice were subjected to CA and cardiopulmonary resuscitation (CPR). After return of spontaneous circulation (ROSC), mice received intravenous infusion of propofol, dexmedetomidine (DEX), or normal saline (vehicle) for 2 hours. Body temperature was maintained at 37°C, and was subsequently lowered to 33°C. Cerebral blood flow (CBF) was measured for 4 hours following ROSC. To quantify time-dependent EEG changes, we calculated the sum of the Delta, Theta, and Alpha band power in consecutive 12-hour intervals after ROSC (D 0-12 and D 12-24 , T 0-12 and T 12-24 , and A 0-12 and A 12-24 , respectively). Because the increase in fast EEG activity over time may reflect neurological recovery after CA, we compared the ratios of D 12-24 to D 0-12 , of T 12-24 to T 0-12 , and of A 12-24 to A 0-12 among groups. Results: As compared with vehicle-treated mice, propofol- or DEX-treated mice exhibited improved survival rate and neurological function after CA, though no difference was found between propofol- and DEX-treated mice. In the vehicle group, CBF was higher than the baseline after ROSC, while the increase in CBF was attenuated in the propofol and DEX group. The values of A 12-24 /A 0-12 and T 12-24 /T 0-12 were significantly higher in propofol- and DEX-treated mice than in vehicle-treated mice ( P = 0.017 and P = 0.004, respectively, propofol vs vehicle; P = 0.038 and P = 0.002, respectively, DEX vs vehicle), but there was no significant difference in D 12-24 /D 0-12 among groups. In all post-arrest mice, both A 12-24 /A 0-12 and T 12-24 /T 0-12 were positively correlated with better neurological function at 24 and 48 hours after CA. Conclusions: Post-arrest sedation was associated with a reduction in CBF and a greater recovery of fast EEG activity after CA, and improved neurological outcomes and survival in mice.

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P5349Platelet/lymphocyte ratio as an inflammatory marker and predictor of short-term neurological outcomes in survivors after cardiac arrest

European Heart Journal ◽

10.1093/eurheartj/ehz746.0316 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

L Rodriguez ◽

L A Martinez ◽

S O Rosillo ◽

L Martin ◽

C Merino ◽

...

Keyword(s):

Cardiac Arrest ◽

Paired Comparison ◽

Inflammatory Marker ◽

Cerebral Performance Category ◽

Temperature Management ◽

Target Temperature Management ◽

Early Assessment ◽

Lymphocyte Ratio ◽

Neurological Outcomes ◽

The Impact

Abstract Background Platelet/lymphocyte ratio (PLR), an inflammatory marker associated with poor outcomes in different clinical situations, may play a role in the proinflammatory state triggered during hypoxic-ischemic brain injury secondary to cardiac arrest. Purpose To study PLR dynamics and its relationship with neurologic outcomes in survivors after CA treated with target-temperature-management (TTM). Methods Observational retrospective study from a prospective database of survivors of in-hospital and out-of-hospital CA admitted to our Acute Cardiac Care Unit between August 2006 to December 2018. All patients received TTM according to our local protocol. Results A total of 466 patients were included. Mean age was 62.7±14.4 years and 102 (21.9%) were women. Baseline characteristics are shown in Table 1. 430 (92.2%) of CA were witnessed, 312 (67.0%) had ventricular fibrillation as initial cardiac rhythm. Among them, 236 (51.1%) survived until hospital discharge and 208 (45.1%) presented favorable neurological outcomes (a score 1 or 2 on cerebral performance category (CPC)). The mean value of PLR at admission and during targeted temperature was 100.4±5.2 and 224.5±7.3 respectively (mean difference 123.1±7.1, p<0.0001). This increase in PLR was significantly higher among patients with worse neurological outcomes (CPC 3–5, mean DPLR 138.2±5.5) at 3 months compared with survivors with CPC 1–2 (mean DPLR 108.2±6.3, p=0.0348 for paired comparison between both groups). Table 1 Hypertension, n (%) 235 (54.9) Diabetes, n (%) 113 (26.4) Dyslipidaemia, n (%) 171 (40.0) Smocking habit, n (%) 208 (48.5) Time to ROSC mean ± SD, min 26.6±18.6 Mean arterial pressure at HA mean±DS, mmHg 81.3±22.1 pH at HA mean ± SD 7.18±0.16 Lactic at HA mean ± SD 6.37±4.42 ROSC: return of spontaneus circulation; HA: hospital admission. Conclusion Our findings reflect the impact of inflammation in neurological outcomes after OHCA treated with TTM. Major increases of PLR constitute a novel marker of poor prognosis during early assessment of OHCA patients.

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Does SLE widen or narrow race/ethnic disparities in the risk of five co-morbid conditions? Evidence from a community-based outpatient care system

Lupus ◽

10.1177/0961203319884646 ◽

2019 ◽

Vol 28 (14) ◽

pp. 1619-1627 ◽

Cited By ~ 1

Author(s):

T Falasinnu ◽

Y Chaichian ◽

J Li ◽

S Chung ◽

B E Waitzfelder ◽

...

Keyword(s):

Lupus Erythematosus ◽

Minority Groups ◽

Ethnic Disparities ◽

Cross Product ◽

Outpatient Setting ◽

Secondary Complications ◽

Community Based ◽

Product Term ◽

Racial Ethnic ◽

Cross Product Term

Objective The heterogeneous spectrum of systemic lupus erythematosus (SLE) often presents with secondary complications such as cardiovascular disease (CVD), infections and neoplasms. Our study assessed whether the presence of SLE independently increases or reduces the disparities, accounting for the already higher risk of these outcomes among racial/ethnic minority groups without SLE. Methods We defined a cohort using electronic health records data (2005–2016) from a mixed-payer community-based outpatient setting in California serving patients of diverse racial/ethnic backgrounds. The eligible population included adult patients with SLE and matched non-SLE patients (≥18 years old). SLE was the primary exposure. The following outcomes were identified: pneumonia, other infections, CVD and neoplasms. For each racial/ethnic group, we calculated the proportion of incident co-morbidities by SLE exposure, followed by logistic regression for each outcome with SLE as the exposure. We evaluated interaction on the additive and multiplicative scales by calculating the relative excess risk due to interaction and estimating the cross-product term in each model. Results We identified 1036 SLE cases and 8875 controls. The incidence for all outcomes was higher among the SLE exposed. We found little difference in the odds of the outcomes associated with SLE across racial/ethnic groups, even after multivariable adjustment. This finding was consistent on the multiplicative and additive scales. Conclusion We demonstrated that SLE status does not independently confer substantial interaction or heterogeneity by race/ethnicity toward the risk of pneumonia, other infections, CVD or neoplasms. Further studies in larger datasets are necessary to validate this novel finding.

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Lactate Clearance Predicts Good Neurological Outcomes in Cardiac Arrest Patients Treated with Extracorporeal Cardiopulmonary Resuscitation

Journal of Clinical Medicine ◽

10.3390/jcm8030374 ◽

2019 ◽

Vol 8 (3) ◽

pp. 374 ◽

Cited By ~ 10

Author(s):

Christian Jung ◽

Sandra Bueter ◽

Bernhard Wernly ◽

Maryna Masyuk ◽

Diyar Saeed ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Cox Regression ◽

Lactate Concentration ◽

Lactate Clearance ◽

Serum Lactate ◽

Extracorporeal Cardiopulmonary Resuscitation ◽

Neurological Outcomes ◽

Baseline Characteristics ◽

The Impact

Background: We evaluated critically ill patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) due to cardiac arrest (CA) with respect to baseline characteristics and laboratory assessments, including lactate and lactate clearance for prognostic relevance. Methods: The primary endpoint was 30-day mortality. The impact on 30-day mortality was assessed by uni- and multivariable Cox regression analyses. Neurological outcome assessed by Glasgow Outcome Scale (GOS) was pooled into two groups: scores of 1–3 (bad GOS score) and scores of 4–5 (good GOS score). Results: A total of 93 patients were included in the study. Serum lactate concentration (hazard ratio (HR) 1.09; 95% confidence interval (CI) 1.04–1.13; p < 0.001), hemoglobin, (Hb; HR 0.87; 95% CI 0.79–0.96; p = 0.004), and catecholamine use were associated with 30-day-mortality. In a multivariable model, only lactate clearance (after 6 h; OR 0.97; 95% CI 0.94–0.997; p = 0.03) was associated with a good GOS score. The optimal cut-off of lactate clearance at 6 h for the prediction of a bad GOS score was at ≤13%. Patients with a lactate clearance at 6 h ≤13% evidenced higher rates of bad GOS scores (97% vs. 73%; p = 0.01). Conclusions: Whereas lactate clearance does not predict mortality, it was the sole predictor of good neurological outcomes and might therefore guide clinicians when to stop ECPR.

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