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Global mortality of children after perioperative cardiac arrest: A systematic review, meta-analysis, and

Semagn Mekonnen Abate1, Solomon Nega2, Bivash Basu1

  • 1Department of Anesthesiology, College of Health Sciences and Medicine, Dilla University, Ethiopia.

Annals of Medicine and Surgery (2012)
|March 4, 2022
PubMed

Insights

Pediatric perioperative cardiac arrest and mortality remain high, especially in low-income countries. This systematic review highlights the need for improved medical education and adherence to standard protocols to enhance child survival rates.

Area of Science:

  • Anesthesiology and Perioperative Medicine
  • Pediatric Critical Care
  • Global Health Outcomes

Background:

  • Global trends in perioperative cardiac arrest and mortality show significant variations over time, particularly in low and middle-income nations.
  • Uncertainty persists regarding the survival rates and independent predictors of cardiac arrest in children.
  • This study addresses these uncertainties through a systematic review of published literature.

Purpose of the Study:

  • To investigate the mortality rates of children following perioperative cardiac arrest.
  • To systematically review and analyze existing peer-reviewed literature on pediatric perioperative cardiac arrest and mortality.
  • To identify trends and potential contributing factors to pediatric perioperative cardiac arrest.

Main Methods:

  • A comprehensive literature search was conducted across PubMed/Medline, Science direct, CINHAL, and LILACS from December 2000 to August 2021.
  • Included were observational studies reporting perioperative cardiac arrest (CA) rates in children.
  • Data extraction and methodological quality assessment were performed by two independent authors using a customized format and the Newcastle-Ottawa appraisal tool.

Main Results:

  • The search identified 397 articles, with 38 studies involving 3.35 million participants included in the meta-analysis.
  • The global incidence of perioperative cardiac arrest was found to be 2.54 per 1000 anesthetics (95% CI: 2.23–2.84).
  • The global incidence of perioperative mortality was 41.18 per 1000 anesthetics (95% CI: 35.68–46.68).

Conclusions:

  • Anesthesia-related pediatric cardiac arrest and mortality rates have remained persistently high over the past two decades, particularly in low and middle-income countries.
  • There is a critical need for increased investment in continuous medical education for perioperative staff.
  • Adherence to international standard operating protocols for common procedures and critical situations is essential to improve outcomes.
Abstract

Keywords:
Anesthesia-relatedCardiac arrestIncidenceMortality

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