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
. 2021 Aug;180(8):2513-2520.
doi: 10.1007/s00431-021-04082-3. Epub 2021 Apr 26.

Survival outcomes of in-hospital cardiac arrest in pediatric patients in the USA

Mohammed Hamzah #  1 , Hasan F Othman #  2 , Murad Almasri  3 , Awni Al-Subu  4 , Riad Lutfi  5
Affiliations
Free article

Survival outcomes of in-hospital cardiac arrest in pediatric patients in the USA

Mohammed Hamzah et al. Eur J Pediatr. 2021 Aug.
Free article

Abstract

We report on in-hospital cardiac arrest outcomes in the USA. The data were obtained from the National (Nationwide) Inpatient Sample datasets for the years 2000-2017, which includes data from participating hospitals in 47 US states and the District of Columbia. We included pediatric patients (< 18 years of age) with cardiac arrest, and we excluded patients with no cardiopulmonary resuscitation during the hospitalization. Primary outcome of the study was in-hospital mortality after cardiac arrest. A multivariable logistic regression was performed to identify factors associated with survival. A total of 20,654 patients were identified, and 8226 (39.82%) patients survived to discharge. The median length of stay and cost of hospitalization were significantly higher in the survivors vs. non-survivors (LOS 18 days vs. 1 day, and cost $187,434 vs. $45,811, respectively, p < 0.001). In a multivariable model, patients admitted to teaching hospitals, elective admissions, and those admitted on weekdays had higher survival (aOR=1.19, CI: 1.06-1.33; aOR=2.65, CI: 2.37-2.97; and aOR=1.17, CI: 1.07-1.27, respectively). There was no difference in mortality between patients with extracorporeal cardiopulmonary resuscitation (E-CPR) and those with conventional cardiopulmonary resuscitation. E-CPR patients were likely to have congenital heart surgery (51.0% vs. 20.8%).Conclusion: We highlighted the survival predictors in these events, which can guide future studies aimed at improving outcomes in pediatric cardiac arrest. What is Known: • In-hospital cardiac arrest occurs in 2-6% of pediatric intensive care admissions. • Cardiac arrests had a significant impact on hospital resources and a significantly high mortality rate. What is New: • Factors associated with higher survival rates in patients with cardiac arrest: admission to teaching hospitals, elective admissions, and week-day admissions. • The use of rescue extracorporeal cardiopulmonary resuscitation in refractory cardiac arrest has increased by threefold over the last two decades.

Keywords: Cardiac arrest; Cardiopulmonary resuscitation; Extracorporeal membrane oxygenation; Pediatric; Survival.

PubMed Disclaimer

References

    1. Holmberg MJ, Ross CE, Fitzmaurice GM, Chan PS, Duval-Arnould J, Grossestreuer AV, Yankama T, Donnino MW, Andersen LW, for the American Heart Association’s Get With The Guidelines–Resuscitation Investigators*, Chan P, Grossestreuer AV, Moskowitz A, Edelson D, Ornato J, Berg K, Peberdy MA, Churpek M, Kurz M, Starks MA, Girotra S, Perman S, Goldberger Z, Guerguerian AM, Atkins D, Foglia E, Fink E, Lasa JJ, Roberts J, Bembea M, Gaies M, Kleinman M, Gupta P, Sutton R, Sawyer T (2019) Annual incidence of adult and pediatric in-hospital cardiac arrest in the United States. Circ Cardiovasc Qual Outcomes 12:1–8. https://doi.org/10.1161/CIRCOUTCOMES.119.005580 - DOI
    1. Berg RA, Nadkarni VM, Clark AE, Moler F, Meert K, Harrison RE, Newth CJ, Sutton RM, Wessel DL, Berger JT, Carcillo J, Dalton H, Heidemann S, Shanley TP, Zuppa AF, Doctor A, Tamburro RF, Jenkins TL, Dean JM, Holubkov R, Pollack MM, Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (2016) Incidence and outcomes of cardiopulmonary resuscitation in PICUs. Crit Care Med 44:798–808. https://doi.org/10.1097/CCM.0000000000001484 - DOI - PubMed - PMC
    1. Holmberg MJ, Wiberg S, Ross CE, Kleinman M, Hoeyer-Nielsen AK, Donnino MW, Andersen LW, For the American Heart Association’s Get With The Guidelines-Resuscitation Investigators (2019) Trends in survival after pediatric in-hospital cardiac arrest in the United States. Circulation 140:1398–1408. https://doi.org/10.1161/CIRCULATIONAHA.119.041667 - DOI - PubMed - PMC
    1. Girotra S, Spertus JA, Li Y, Berg RA, Nadkarni VM, Chan PS, for the American Heart Association Get With the Guidelines–Resuscitation Investigators (2013) Survival trends in pediatric in-hospital cardiac arrests an analysis from get with the guidelines-resuscitation. Circ Cardiovasc Qual Outcomes 6:42–49. https://doi.org/10.1161/CIRCOUTCOMES.112.967968 - DOI - PubMed
    1. Berg RA, Sutton RM, Reeder RW, Berger JT, Newth CJ, Carcillo JA, McQuillen PS, Meert KL, Yates AR, Harrison RE, Moler FW, Pollack MM, Carpenter TC, Wessel DL, Jenkins TL, Notterman DA, Holubkov R, Tamburro RF, Dean JM, Nadkarni VM, Zuppa AF, Graham K, Twelves C, Landis W, DiLiberto MA, Tomanio E, Kwok J, Bell MJ, Abraham A, Sapru A, Alkhouli MF, Heidemann S, Pawluszka A, Hall MW, Steele L, Shanley TP, Weber M, Dalton HJ, Bell AL, Mourani PM, Malone K, Telford R, Coleman W, Peterson A, Thelen J, Doctor A, CPCCRN PICqCPR Investigators (2018) Association between diastolic blood pressure during pediatric in-hospital cardiopulmonary resuscitation and survival. Circulation 137:1784–1795. https://doi.org/10.1161/CIRCULATIONAHA.117.032270 - DOI - PubMed