Global Mortality of Children After Perioperative Cardiac Arrest: A Systematic Review, Meta-analysis, and Meta-regression

Overview

Journal Ann Med Surg (Lond)

Publisher Wolters Kluwer

Specialty Medical Education

Date 2022 Mar 4

PMID 35242308

Authors

Semagn Mekonnen Abate

Solomon Nega

Bivash Basu

Kidanemariam Tamrat

Affiliations

Soon will be listed here.

Abstract

Background: The body of evidence showed that perioperative cardiac arrest and mortality trends varied globally over time particularly in low and middle-income nations. However, the survival of children after cardiac arrest and its independent predictors are still uncertain and a topic of debate. This study was designed to investigate the mortality of children after a perioperative cardiac arrest based on a systematic review of published peer-reviewed literature.

Methods: A comprehensive search was conducted in PubMed/Medline; Science direct, CINHAL, and LILACS from December 2000 to August 2021. All observational studies reporting the rate of perioperative CA among children were included. The data were extracted with two independent authors in a customized format. The methodological quality of the included studies was evaluated using the Newcastle-Ottawa appraisal tool.

Results: A total of 397 articles were identified from different databases. Thirty-eight studies with 3.35 million participants were included. The meta-analysis revealed that the global incidence of perioperative cardiac arrest was 2.54(95% CI: 2.23 to 2.84) per 1000 anesthetics. The global incidence of perioperative mortality was 41.18 (95% CI: 35.68 to 46.68) per 1000 anesthetics.

Conclusion: The incidence of anesthesia-related pediatric cardiac arrest and mortality is persistently high in the last twenty years in low and middle-income countries. This probes an investment in continuous medical education of the perioperative staff and adhering with the international standard operating protocols for common procedures and critical situations.

Registration: This systematic review and meta-analysis is registered in the research registry (UIN: researchregistry6932).

Citing Articles

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

Braz L, Tiradentes T, Braz J Ann Med Surg (Lond). 2022; 79:103970.

PMID: 35757306 PMC: 9213694. DOI: 10.1016/j.amsu.2022.103970.

References

Flick R, Sprung J, Harrison T, Gleich S, Schroeder D, Hanson A . Perioperative cardiac arrests in children between 1988 and 2005 at a tertiary referral center: a study of 92,881 patients. Anesthesiology. 2007; 106(2):226-37. DOI: 10.1097/00000542-200702000-00009. View

Lee A, Reduque L, Luban N, Ness P, Anton B, Heitmiller E . Transfusion-associated hyperkalemic cardiac arrest in pediatric patients receiving massive transfusion. Transfusion. 2013; 54(1):244-54. DOI: 10.1111/trf.12192. View

Shea B, Reeves B, Wells G, Thuku M, Hamel C, Moran J . AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017; 358:j4008. PMC: 5833365. DOI: 10.1136/bmj.j4008. View

Yates A, Sutton R, Reeder R, Meert K, Berger J, Fernandez R . Survival and Cardiopulmonary Resuscitation Hemodynamics Following Cardiac Arrest in Children With Surgical Compared to Medical Heart Disease. Pediatr Crit Care Med. 2019; 20(12):1126-1136. PMC: 6895416. DOI: 10.1097/PCC.0000000000002088. View

Newland M, Ellis S, Lydiatt C, Peters K, Tinker J, Romberger D . Anesthetic-related cardiac arrest and its mortality: a report covering 72,959 anesthetics over 10 years from a US teaching hospital. Anesthesiology. 2002; 97(1):108-15. DOI: 10.1097/00000542-200207000-00016. View

Pignaton W, Braz J, Kusano P, Modolo M, de Carvalho L, Braz M . Perioperative and Anesthesia-Related Mortality: An 8-Year Observational Survey From a Tertiary Teaching Hospital. Medicine (Baltimore). 2016; 95(2):e2208. PMC: 4718226. DOI: 10.1097/MD.0000000000002208. View

Talabi A, Sowande O, Adenekan A, Adejuyigbe O, Adumah C, Igwe A . A 10-year retrospective review of perioperative mortality in pediatric general surgery at Ile-Ife Hospital, Nigeria. J Pediatr Surg. 2018; 53(10):2072-2076. DOI: 10.1016/j.jpedsurg.2018.03.005. View

Posner K, Geiduschek J, Haberkern C, Ramamoorthy C, Hackel A, Morray J . Unexpected cardiac arrest among children during surgery, a North American registry to elucidate the incidence and causes of anesthesia related cardiac arrest. Qual Saf Health Care. 2002; 11(3):252-7. PMC: 1743630. DOI: 10.1136/qhc.11.3.252. View

Haller G, Stoelwinder J, Myles P, McNeil J . Quality and safety indicators in anesthesia: a systematic review. Anesthesiology. 2009; 110(5):1158-75. DOI: 10.1097/ALN.0b013e3181a1093b. View

10.

Bhananker S, Ramamoorthy C, Geiduschek J, Posner K, Domino K, Haberkern C . Anesthesia-related cardiac arrest in children: update from the Pediatric Perioperative Cardiac Arrest Registry. Anesth Analg. 2007; 105(2):344-50. DOI: 10.1213/01.ane.0000268712.00756.dd. View

11.

Lalwani K, Aliason I . Cardiac arrest in the neonate during laparoscopic surgery. Anesth Analg. 2009; 109(3):760-2. DOI: 10.1213/ane.0b013e3181adc6f9. View

12.

Disma N, Leva B, Dowell J, Veyckemans F, Habre W . Assessing anaesthesia practice in the vulnerable age group: NECTARINE: A European prospective multicentre observational study. Eur J Anaesthesiol. 2016; 33(4):233-5. DOI: 10.1097/EJA.0000000000000414. View

13.

Rose J, Weiser T, Hider P, Wilson L, Gruen R, Bickler S . Estimated need for surgery worldwide based on prevalence of diseases: a modelling strategy for the WHO Global Health Estimate. Lancet Glob Health. 2015; 3 Suppl 2:S13-20. PMC: 5746187. DOI: 10.1016/S2214-109X(15)70087-2. View

14.

Bainbridge D, Martin J, Arango M, Cheng D . Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis. Lancet. 2012; 380(9847):1075-81. DOI: 10.1016/S0140-6736(12)60990-8. View

15.

Murat I, Constant I, Maudhuy H . Perioperative anaesthetic morbidity in children: a database of 24,165 anaesthetics over a 30-month period. Paediatr Anaesth. 2004; 14(2):158-66. DOI: 10.1111/j.1460-9592.2004.01167.x. View

16.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

17.

Braz L, Braz J, Modolo M, Corrente J, Sanchez R, Pacchioni M . Perioperative and anesthesia-related cardiac arrest and mortality rates in Brazil: A systematic review and proportion meta-analysis. PLoS One. 2020; 15(11):e0241751. PMC: 7605701. DOI: 10.1371/journal.pone.0241751. View

18.

Bunchungmongkol N, Punjasawadwong Y, Chumpathong S, Somboonviboon W, Suraseranivongse S, Vasinanukorn M . Anesthesia-related cardiac arrest in children: the Thai Anesthesia Incidents Study (THAI Study). J Med Assoc Thai. 2009; 92(4):523-30. View

19.

Newton M, Hurt S, McEvoy M, Shi Y, Shotwell M, Kamau J . Pediatric Perioperative Mortality in Kenya: A Prospective Cohort Study from 24 Hospitals. Anesthesiology. 2019; 132(3):452-460. DOI: 10.1097/ALN.0000000000003070. View

20.

Habre W, Disma N, Virag K, Becke K, Hansen T, Johr M . Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe. Lancet Respir Med. 2017; 5(5):412-425. DOI: 10.1016/S2213-2600(17)30116-9. View