In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
Abstract:
Introduction: Contemporary rates of survival after pediatric in-hospital cardiac arrest (IHCA) and trends in survival over the last 20 years have not been compared based on illness category. We hypothesized that (1) survival to hospital discharge for surgical-cardiac category is higher than the non-cardiac category, and (2) rates of survival after IHCA increased over time in all categories. Methods: The AHA Get With The Guidelines ® -Resuscitation database was queried for index IHCA events (excluding delivery room and neonatal intensive care unit) in children 〈 18 years of age from 2000-2021. Categories were defined as: surgical-cardiac, IHCA following cardiac surgery; medical-cardiac, IHCA in non-surgical cardiac disease; and non-cardiac, IHCA in patients without cardiac disease. The primary outcome was survival to hospital discharge. We compared eras 2000-2004, 2005-2009, 2010-2014, and 2015-2021 with mixed logistic regression models, including event year as a continuous predictor and site as a random effect. Results: Of 17,696 index events, IHCA by illness category were: 18% surgical-cardiac, 18% medical-cardiac, and 64% non-cardiac. Surgical-cardiac category had the highest rate of survival to discharge compared to medical-cardiac and non-cardiac categories (56.1% vs. 43.4% vs. 46.3%; p 〈 0.001). After controlling for age, location of event, and hospital size, the odds of survival were higher for surgical-cardiac category (aOR 1.28 (1.16, 1.40)) and lower for medical-cardiac category (aOR 0.87 (0.80, 0.95)), compared to the non-cardiac category. Odds of survival increased for all illness categories across eras. Between the 2000-2004 and 2015-2021 eras, survival in surgical-cardiac subjects increased from 45.6% to 62.3% with odds of survival increasing by 24% per era, (OR 1.24 (95% CI 1.15, 1.35), and survival for medical-cardiac subjects increased from 36.6% to 47.0%, with 14% increased odds per era (OR 1.14 (1.06, 1.23)). Conclusions: Over the last 20 years, children with surgical-cardiac IHCA have substantially higher odds of survival to hospital discharge compared to non-cardiac IHCA categories, whereas odds of survival were worse with medical-cardiac IHCA. Survival to hospital discharge has increased in all IHCA illness categories.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.146.suppl_1.287
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
1466401-X
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