Trends in Cardiac Arrest Outcomes & Management in Children with Cardiac Illness Category Compared to Non-Cardiac Illness Category: An Analysis from the AHA Get With The Guidelines®-Resuscitation Registry

Gardner, MM; Morgan, RW; Reeder, R; Ghaffari, K; Ortmann, L; Raymond, T; Lasa, JJ; Fowler, J; Dewan, M; Nadkarni, V; Berg, RA; Sutton, R; Topjian, A; American Heart Association’s Get With The Guidelines, ®-Resuscitation Investigators

doi:10.1016/j.resuscitation.2024.110430

Acute cardiac care & resuscitation

Trends in Cardiac Arrest Outcomes & Management in Children with Cardiac Illness Category Compared to Non-Cardiac Illness Category: An Analysis from the AHA Get With The Guidelines®-Resuscitation Registry

ResuscitationPublished 13 Nov 2024Retrospective registry cohort study

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Authors' conclusion

Over the last 20 years, both survival to hospital discharge and ECPR use has increased in all in-hospital CPR event illness categories. Children with surgical-cardiac CPR event have higher odds of survival to hospital discharge compared to non-cardiac CPR event categories, whereas odds of survival were lowest with medical-cardiac CPR events.

Study context

Population: Children <18 years with index in-hospital CPR events, AHA Get With The Guidelines-Resuscitation registry, 2000–2021
Participants: 16,241 index events

Exposure: Surgical-cardiac vs medical-cardiac vs non-cardiac illness category
Outcome: Survival to hospital discharge

Methodological detailsmulticentre registry, mixed logistic regression with site as random effect

Multicentre registry
Mixed logistic regression with site as random effect

Main finding

As reported in the abstract

Surgical-cardiac56 %

Medical-cardiac44 %

Non-cardiac46 %

Unadjusted survival across the categories: P < 0.001

Observational data: associations, not effects.

Further findings

Trend in survival over eras (2000-2004 to 2015-2021)

Odds of survival increased for all illness categories; medical-cardiac had the lowest increased odds per era

Extracorporeal resuscitation (ECPR) use

%

Highest ECPR rates in surgical-cardiac; ECPR across the cohort: 20
Greatest increase in ECPR use in non-cardiac (increased odds per era): 52

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Reference

Authors: Gardner MM, Morgan RW, Reeder R, Ghaffari K, Ortmann L, Raymond T, et al.
All 14 authors
Gardner MM, Morgan RW, Reeder R, Ghaffari K, Ortmann L, Raymond T, Lasa JJ, Fowler J, Dewan M, Nadkarni V, Berg RA, Sutton R, Topjian A, American Heart Association’s Get With The Guidelines, ®-Resuscitation Investigators
Journal: Resuscitation
Published: 13 Nov 2024
DOI: 10.1016/j.resuscitation.2024.110430
PubMed: 40071352

Country: United States
Topic: Acute cardiac care & resuscitation

Exposure definitions

Surgical-cardiac: in-hospital CPR event following cardiac surgery
Medical-cardiac: CPR event in non-surgical cardiac disease
Non-cardiac: CPR event in patients without cardiac disease

Key notes

Odds of survival increased for all categories from 2000-2004 era to 2015-2021 era; medical-cardiac had the lowest increased odds per era

Original publication

Trends in Cardiac Arrest Outcomes & Management in Children with Cardiac Illness Category Compared to Non-Cardiac Illness Category: An Analysis from the AHA Get With The Guidelines®-Resuscitation Registry. Resuscitation. Published 13 November 2024. doi:10.1016/j.resuscitation.2024.110430

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