Cardiac Arrest Survival in Pediatric and General Emergency Departments

Overview

Journal Pediatrics

Specialty Pediatrics

Date 2018 Jan 26

PMID 29367204

Citations 19

Authors

Kenneth A Michelson

Joel D Hudgins

Michael C Monuteaux

Richard G Bachur

Jonathan A Finkelstein

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Pediatric out-of-hospital cardiac arrest (OHCA) has a low rate of survival to hospital discharge. Understanding whether pediatric emergency departments (EDs) have higher survival than general EDs may help identify ways to improve care for all patients with OHCA. We sought to determine if OHCA survival differs between pediatric and general EDs.

Methods: We used the 2009-2014 Nationwide Emergency Department Sample to study children under 18 with cardiac arrest. We compared pediatric EDs (those with >75% pediatric visits) to general EDs on the outcome of survival to hospital discharge or transfer. We determined unadjusted and adjusted survival, accounting for age, region, and injury severity. Analyses were stratified by nontraumatic versus traumatic cause.

Results: The incidences of nontraumatic and traumatic OHCA were 7.91 (95% confidence interval [CI]: 7.52-8.30) and 2.67 (95% CI: 2.49-2.85) per 100 000 person years. In nontraumatic OHCA, unadjusted survival was higher in pediatric EDs than general EDs (33.8% vs 18.9%, < .001). The adjusted odds ratio of survival in pediatric versus general EDs was 2.2 (95% CI: 1.7-2.8). Children with traumatic OHCA had similar survival in pediatric and general EDs (31.7% vs 26.1%, = .14; adjusted odds ratio = 1.3 [95% CI: 0.8-2.1]).

Conclusions: In a nationally representative sample, survival from nontraumatic OHCA was higher in pediatric EDs than general EDs. Survival did not differ in traumatic OHCA. Identifying the features of pediatric ED OHCA care leading to higher survival could be translated into improved survival for children nationally.

Citing Articles

Defining Levels of US Hospitals' Pediatric Capabilities.

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Out-of-Hospital Cardiac Arrest in the Paediatric Patient: An Observational Study in the Context of National Regulations.

Pireddu R, Ristagno G, Gianquintieri L, Bonora R, Pagliosa A, Andreassi A J Clin Med. 2024; 13(11).

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National Characteristics of Emergency Care for Children with Neurologic Complex Chronic Conditions.

Jafari K, Carlin K, Caglar D, Klein E, Simon T West J Emerg Med. 2024; 25(2):237-245.

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Survival in a young child with out-of-hospital cardiac arrest: diagnostic dilemma and when to deviate from standard resuscitation guidelines.

Collins N, Finn D, OMahony O, Walsh M BMJ Case Rep. 2023; 16(10).

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Implementation of a North American pediatric emergency medicine simulation curriculum using the virtual resuscitation room.

Leung J, Foohey S, Burns R, Bank I, Nemeth J, Sanseau E AEM Educ Train. 2023; 7(3):e10868.

PMID: 37215281 PMC: 10199309. DOI: 10.1002/aet2.10868.

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