Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb;141(2):e20172741.
doi: 10.1542/peds.2017-2741.

Cardiac Arrest Survival in Pediatric and General Emergency Departments

Kenneth A Michelson  1 , Joel D Hudgins  2 , Michael C Monuteaux  2 , Richard G Bachur  2 , Jonathan A Finkelstein  3
Affiliations

Cardiac Arrest Survival in Pediatric and General Emergency Departments

Kenneth A Michelson et al. Pediatrics. 2018 Feb.

Abstract

Background and objectives: Pediatric out-of-hospital cardiac arrest (OHCA) has a low rate of survival to hospital discharge. Understanding whether pediatric emergency departments (EDs) have higher survival than general EDs may help identify ways to improve care for all patients with OHCA. We sought to determine if OHCA survival differs between pediatric and general EDs.

Methods: We used the 2009-2014 Nationwide Emergency Department Sample to study children under 18 with cardiac arrest. We compared pediatric EDs (those with >75% pediatric visits) to general EDs on the outcome of survival to hospital discharge or transfer. We determined unadjusted and adjusted survival, accounting for age, region, and injury severity. Analyses were stratified by nontraumatic versus traumatic cause.

Results: The incidences of nontraumatic and traumatic OHCA were 7.91 (95% confidence interval [CI]: 7.52-8.30) and 2.67 (95% CI: 2.49-2.85) per 100 000 person years. In nontraumatic OHCA, unadjusted survival was higher in pediatric EDs than general EDs (33.8% vs 18.9%, P < .001). The adjusted odds ratio of survival in pediatric versus general EDs was 2.2 (95% CI: 1.7-2.8). Children with traumatic OHCA had similar survival in pediatric and general EDs (31.7% vs 26.1%, P = .14; adjusted odds ratio = 1.3 [95% CI: 0.8-2.1]).

Conclusions: In a nationally representative sample, survival from nontraumatic OHCA was higher in pediatric EDs than general EDs. Survival did not differ in traumatic OHCA. Identifying the features of pediatric ED OHCA care leading to higher survival could be translated into improved survival for children nationally.

PubMed Disclaimer

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Comment in

References

    1. Meyer L, Stubbs B, Fahrenbruch C, et al. Incidence, causes, and survival trends from cardiovascular-related sudden cardiac arrest in children and young adults 0 to 35 years of age: a 30-year review. Circulation. 2012;126(11):1363–1372 - PubMed
    1. Atkins DL, Everson-Stewart S, Sears GK, et al. ; Resuscitation Outcomes Consortium Investigators . Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. Circulation. 2009;119(11):1484–1491 - PMC - PubMed
    1. Donoghue AJ, Nadkarni V, Berg RA, et al. ; CanAm Pediatric Cardiac Arrest Investigators . Out-of-hospital pediatric cardiac arrest: an epidemiologic review and assessment of current knowledge. Ann Emerg Med. 2005;46(6):512–522 - PubMed
    1. Jayaram N, McNally B, Tang F, Chan PS. Survival after out-of-hospital cardiac arrest in children. J Am Heart Assoc. 2015;4(10):e002122. - PMC - PubMed
    1. Schindler MB, Bohn D, Cox PN, et al. Outcome of out-of-hospital cardiac or respiratory arrest in children. N Engl J Med. 1996;335(20):1473–1479 - PubMed

Publication types

LinkOut - more resources