Acute cardiac care & resuscitation
Risk-standardizing hospital rates of survival for pediatric in-hospital cardiopulmonary resuscitation (CPR) events
Authors' conclusion
We developed and validated a model to risk-standardize hospital rates of survival for children undergoing CPR, including those with bradycardia and poor perfusion. This model can facilitate efforts to benchmark hospitals in resuscitation outcomes for children.
Study context
- Population
- Children who underwent in-hospital CPR within Get With the Guidelines-Resuscitation between 2016 and 2023children who underwent CPR
- Participants
- 8,080 children
- Comparison
- Model for survival to hospital discharge to calculate risk-standardized survival rates (RSSRs) for hospitals
- Outcome
- Bradycardia with poor perfusion share of pediatric CPR events
Methodological detailshierarchical logistic regression
- Hierarchical logistic regression
Main finding
As reported in the abstract
Bradycardia with poor perfusion
56.4%
Further findings
Model discrimination
- Full model, 16 predictors, derivation cohort, c-statistic
- 0.772
- Parsimonious model, 13 predictors, c-statistic
- 0.769
Calibration in validation cohort
- R2
- 0.993
Hospital RSSR among 100 hospitals with ≥5 CPR events
- Median RSSR
- 51.8% (IQR: 50.1-54.5%; range: 40.5-62.9%)
Between-hospital variation in survival to discharge
- Adjusted median OR
- 1.32 (95% CI: 1.18-1.43)
- Odds of survival to discharge for two children with similar characteristics varied by 32% between hospitals
Final predictors
- Age group, illness category, initial rhythm, arrest location, renal insufficiency, hepatic insufficiency, sepsis, metabolic or electrolyte abnormality, metastatic or hematologic malignancy, cardiac acyanotic congenital abnormality, congenital noncardiac abnormality, and mechanical ventilation or continuous intravenous vasopressor at the time of the CPR event
Original publication
Risk-standardizing hospital rates of survival for pediatric in-hospital CPR events. Resuscitation. Published 17 April 2025. doi:10.
Summarised from the published abstract; every number is checked against it