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Factors associated with mortality in pediatric in-hospital cardiac arrest: a prospective multicenter multinational

Jesús López-Herce1, Jimena Del Castillo, Martha Matamoros

  • 1Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Dr Castelo 47, 28009 Madrid, Spain. pielvi@hotmail.com

Intensive Care Medicine
|November 28, 2012
PubMed

Insights

Pediatric in-hospital cardiac arrest (CA) has low survival rates, but survivors often have good neurological outcomes. Improving hospital organization is key to better care for children at risk of CA, especially in pediatric intensive care units (PICUs).

Area of Science:

  • Pediatric Critical Care Medicine
  • Cardiology
  • Resuscitation Science

Background:

  • In-hospital cardiac arrest (CA) in children presents significant challenges in pediatric critical care.
  • Understanding prognostic factors is crucial for improving outcomes in pediatric CA.
  • Previous studies have identified various risk factors, but a comprehensive analysis in a multinational setting is needed.

Purpose of the Study:

  • To identify and analyze prognostic factors associated with in-hospital cardiac arrest (CA) in a pediatric population.
  • To determine factors influencing mortality and survival following pediatric in-hospital CA.
  • To evaluate the neurological outcome of survivors of pediatric in-hospital CA.

Main Methods:

  • A prospective, multicenter, multinational observational study involving 502 children (1 month to 18 years) experiencing in-hospital CA.
  • Data collected across 12 countries.
  • Univariate and multivariate logistic regression analyses were used to assess prognostic factors and their impact on mortality and survival.

Main Results:

  • Survival to hospital discharge was 39.2%, with 88.9% of survivors achieving good neurological outcomes.
  • Factors associated with increased mortality included lower Human Development Index, oncohematologic disease, inotropic drug use, CA due to neurological disease, and CPR duration >10 minutes.
  • Factors associated with survival included CA occurrence in the pediatric intensive care unit (PICU) and shockable rhythm.

Conclusions:

  • Pediatric in-hospital CA has a low survival rate, yet survivors generally experience good neurological recovery.
  • While some risk factors are unmodifiable, enhancing hospital organization, particularly in PICUs and other areas, is vital for managing children at risk of CA.
  • Targeted interventions and improved preparedness in hospital settings can potentially mitigate the impact of CA in children.
Abstract

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