Pediatric anesthesia & critical care
Trends in In-Hospital Cardiac Arrest and Mortality Among Children With Cardiac Disease in the Intensive Care Unit: A Systematic Review and Meta-analysis
Authors' conclusion
This systematic review and meta-analysis found that 5% of children with cardiac disease in the ICU experienced IHCA.
Study context
- Population
- Children with cardiac disease in the intensive care unit (ICU) (age cutoffs ≤18 y to ≤21 y)
- Participants
- 131,724 children · 25 studies
- Outcome
- Incidence of IHCA and in-hospital mortality
Methodological detailsrandom-effects meta-analysis, metaregression
- Random-effects meta-analysis
- Metaregression
Pooled result
As reported in the abstract
- Incidence of in-hospital cardiac arrest (IHCA) (pooled)
- 5% (95% CI, 4%-6%)
- In-hospital mortality after IHCA (pooled)
- 51% (95% CI, 42%-59%)
- Trend in IHCA incidence over last 20 years: significant decrease
- P for trend < .001
- Trend in in-hospital mortality over last 20 years: significant decrease
- P for trend < .001
Further pooled results
No return of spontaneous circulation (ROSC)
- Did not achieve ROSC
- 39% (95% CI, 29%-51%)
- Trend in proportion not achieving ROSC: no significant change
- P for trend = 0.90
ECPR (centers with extracorporeal membrane oxygenation (ECMO))
- Underwent ECPR
- 22% (95% CI, 14%-33%)
- Unable to be resuscitated
- 22% (95% CI, 12%-38%)
Factors associated with IHCA and mortality
- Neonatal age, prematurity, comorbidities, univentricular physiology, arrhythmias, prearrest mechanical ventilation or ECMO, and higher surgical complexity associated with increased IHCA incidence and mortality odds
Original publication
Trends in In-Hospital Cardiac Arrest and Mortality Among Children With Cardiac Disease in the Intensive Care Unit: A Systematic Review and Meta-analysis. JAMA Netw Open. Published 1 February 2023. doi:10.
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