Higher survival rates among younger patients after pediatric intensive care unit cardiac arrests.
Publication/Presentation Date
12-1-2006
Abstract
BACKGROUND: Age is an important determinant of outcome from adult cardiac arrests but has not been identified previously as an important factor in pediatric cardiac arrests except among premature infants. Chest compressions can result in more effective blood flow during cardiac arrest in an infant than an older child or adult because of increased chest wall compliance. We, therefore, hypothesized that survival from cardiac arrest would be better among infants than older children.
METHODS: We evaluated 464 pediatric ICU arrests from the National Registry of Cardiopulmonary Resuscitation from 2000 to 2002. NICU cardiac arrests were excluded. Data from each arrest include >200 variables describing facility, patient, prearrest, arrest intervention, outcome, and quality improvement data. Age was categorized as newborn (<1 >month; N = 62), infant (1 month to <1 >year; N = 105), younger child (1 year to <8 >years; N = 90), and older child (8 years to <21 >years; N = 207). Multivariable logistic regression was performed to examine the association between age and survival.
RESULTS: Overall survival was 22%, with 27% of newborns, 36% of infants, 19% of younger children and 16% of older children surviving to hospital discharge. Newborns and infants demonstrated double and triple the odds of surviving to hospital discharge from a cardiac arrest in an intensive care setting when compared with older children. When potential confounders were controlled, newborns increased their advantage to almost fivefold, while infants maintained their survival advantage to older children.
CONCLUSIONS: Survival from pediatric ICU cardiac arrest is age dependent. Newborns and infants have better survival rates even after adjusting for potential confounding variables.
Volume
118
Issue
6
First Page
2424
Last Page
2433
ISSN
1098-4275
Published In/Presented At
Meaney, P. A., Nadkarni, V. M., Cook, E. F., Testa, M., Helfaer, M., Kaye, W., Larkin, G. L., Berg, R. A., & American Heart Association National Registry of Cardiopulmonary Resuscitation Investigators (2006). Higher survival rates among younger patients after pediatric intensive care unit cardiac arrests. Pediatrics, 118(6), 2424–2433. https://doi.org/10.1542/peds.2006-1724
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
17142528
Department(s)
Department of Pediatrics
Document Type
Article