Abstract
Aim of study
Recurrent in-hospital cardiac arrest (IHCA) is associated with morbidity and mortality
in adults. We aimed to describe the risk factors and outcomes for paediatric recurrent
IHCA.
Methods
Retrospective cohort study of patients ≤18 years old with single or recurrent IHCA.
Recurrent IHCA was defined as ≥2 IHCA within the same hospitalization. Categorical
variables expressed as percentages and compared via Chi square test. Continuous variables
expressed as medians with interquartile ranges and compared via rank sum test. Outcomes
assessed in a propensity match cohort.
Results
From July 1, 2015 to January 26, 2021, 139/894 (15.5%) patients experienced recurrent
IHCA. Compared to patients with a single IHCA, recurrent IHCA patients were more likely
to be trauma and less likely to be surgical cardiac patients. Median duration of cardiopulmonary
resuscitation (CPR) was shorter in the recurrent IHCA (5 vs. 11 min; p < 0.001) with
no difference in IHCA location or immediate cause of CPR. Patients with recurrent
IHCA had worse survival to intensive care unit (ICU) discharge (31% vs. 52%; p < 0.001),
and worse survival to hospital discharge (30% vs. 48%; p < 0.001) in unadjusted analyses
and after propensity matching, patients with recurrent IHCA still had worse survival
to ICU (34% vs. 67%; p < 0.001) and hospital (31% vs. 64%; p < 0.001) discharge.
Conclusion
When examining those with a single vs. a recurrent IHCA, event and patient factors
including more pre-existing conditions and shorter duration of CPR were associated
with risk for recurrent IHCA. Recurrent IHCA is associated with worse survival outcomes
following propensity matching.
Keywords
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Article info
Publication history
Published online: October 18, 2021
Accepted:
October 7,
2021
Received in revised form:
September 9,
2021
Received:
July 16,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
