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Ransomware Cyberattack Associated With Cardiac Arrest Incidence and Outcomes at Untargeted, Adjacent Hospitals.

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Ransomware cyberattacks on healthcare systems increased cardiac arrests (CAs) in adjacent hospitals. Out-of-hospital cardiac arrest (OHCA) survival with favorable neurologic outcomes significantly decreased during the attack period, underscoring the need for cybersecurity preparedness.

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Area of Science:

  • Healthcare Cybersecurity
  • Emergency Medicine
  • Public Health

Background:

  • Healthcare ransomware cyberattacks cause significant disruptions.
  • Limited data exists on patient-oriented outcomes, especially for critical conditions like cardiac arrest (CA), in hospitals adjacent to affected healthcare delivery organizations (HDOs).

Purpose of the Study:

  • To examine the incidence and outcomes of cardiac arrests (CAs) in untargeted hospitals neighboring an HDO experiencing a ransomware cyberattack.

Main Methods:

  • A cohort study compared CA incidence and outcomes in two untargeted academic hospitals adjacent to an HDO during pre-attack, attack, and post-attack phases.
  • Measured variables included daily census, CA numbers, CA incidence per 1,000 admissions, return of spontaneous circulation, survival to discharge, and survival with favorable neurologic outcome.
  • Evaluated 78 total CAs: 44 out-of-hospital CAs (OHCAs) and 34 in-hospital CAs.

Main Results:

  • Total CAs increased during the attack phase (21 vs. 38, p=0.03) and exceeded forecasted numbers (41 observed vs. 27 forecasted).
  • Out-of-hospital cardiac arrest (OHCA) cases also exceeded forecasts (24 observed vs. 12 forecasted).
  • Survival with favorable neurologic outcome rates for OHCAs decreased significantly during the attack phase (40.0% vs. 4.5%, p=0.02), with a subsequent increase post-attack.

Conclusions:

  • Hospitals adjacent to HDOs affected by ransomware may experience worse outcomes for out-of-hospital cardiac arrest (OHCA) patients.
  • Findings emphasize the critical need for robust cybersecurity disaster planning and enhanced healthcare system resiliency.