Pediatric anesthesia & critical care
Characteristics of Pediatric In-Hospital Cardiac Arrests and Resuscitation Duration
An erratum to this article was published (JAMA Netw Open, 1 Aug 2024 ↗)
Authors' conclusion
In this retrospective cohort study of pediatric in-hospital CPR, several factors, including age and event location, were associated with CPR duration in event nonsurvivors. The odds of survival to discharge were lower for patients at hospitals with the shortest and longest median CPR durations among events without ROC.
Study context
- Population
- Children undergoing in-hospital cardiopulmonary resuscitation (CPR) (chest compressions ≥2 minutes and/or defibrillation), US Get With the Guidelines-Resuscitation registry, 2000–2021
- Participants
- 13,899 events
- Exposure
- Hospital quartiles of median CPR duration in events without ROC
- Outcome
- Survival to discharge among all site events (hospital-level analysis)
Methodological detailsmulticentre registry, patient-level and hospital-level analyses, hierarchical regression
- Multicentre registry
- Patient-level and hospital-level analyses
- Hierarchical regression
Main finding
As reported in the abstract
Survival to discharge, all CPR events, by hospital quartile of median CPR duration in events without ROC (hospital-level)
AOR for survival to discharge (95% CI)P value
Quartile 2 (26.0-29.4 minutes) vs Quartile 1 (15.0-25.9 minutes)
1.22(1.09–1.36)
P < 0.001Quartile 3 (29.5-32.9 minutes) vs Quartile 1 (15.0-25.9 minutes)
1.23(1.08–1.39)
P = 0.002Quartile 4 (33.0-53.0 minutes) vs Quartile 1 (15.0-25.9 minutes)
1.04(0.91–1.19)
P = 0.58Observational data: associations, not effects.
Further findings
| Outcome | Difference (minutes) (95% CI) | P value | |
|---|---|---|---|
| Factors associated with median CPR duration in event nonsurvivors (patient-level analysis)Bradycardia with poor perfusion vs Asystole · initial rhythm | 8.37 (5.70–11.03) | P < 0.001 | |
| Factors associated with median CPR duration in event nonsurvivors (patient-level analysis)Pulseless electrical activity vs Asystole · initial rhythm | 8.22 (5.44–11.00) | P < 0.001 | |
| Factors associated with median CPR duration in event nonsurvivors (patient-level analysis)Pulseless ventricular tachycardia vs Asystole · initial rhythm | 6.17 (0.09–12.26) | P = 0.047 | |
| Factors associated with median CPR duration in event nonsurvivors (patient-level analysis)Neonates vs Older children | −4.86 (−8.88 to −0.84) | P = 0.02 | |
| Factors associated with median CPR duration in event nonsurvivors (patient-level analysis)ED location vs PICU location | −4.02 (−7.48 to −0.57) | P = 0.02 | |
| −10−5051015Difference, minutes (linear scale) |
| Outcome | Difference (95% CI) | P value | |
|---|---|---|---|
| Factors associated with median CPR duration in event nonsurvivors (patient-level analysis)Racial or ethnic minority groups vs White patients | −3.67 (−6.18 to −1.17) | P = 0.004 | |
| −10−505Difference (linear scale) |
Original publication
Characteristics of Pediatric In-Hospital Cardiac Arrests and Resuscitation Duration. JAMA Netw Open. Published 1 July 2024. doi:10.
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