Pediatric cardiac arrest in the emergency department: Outcome is related to the time of admission

  • Ali Yurtseven Ege University School of Medicine
  • Caner Turan
  • Funda Karbek Akarca Ege University School of Medicine
  • Eylem Ulaş Saz Ege University School of Medicine
Keywords: Emergency medicine, Pediatrics, resuscitation, Outcomes, Time of admission

Abstract

Objectives: Nights and weekends represent a potentially high-risk time for pediatric cardiac arrest (CA) patients in emergency departments. Data regarding night or weekend arrest and its impact on outcomes is controversial. The purpose of this study was to determine the relationship between cardiopulmonary resuscitation during the various emergency department shifts and survival to discharge.

Methods: We conducted a retrospective, observational study of patients who had visited our Emergency Department for CAs from January 2014 to December 2016. Medical records and patient characteristics of 67 children with CA were retrieved from patient admission files.

Results: The mean age was 54.7±7.3 months and 59% were male. Rates of survival to discharge 35% (11/31) within working hours’ vs. out of working hours 3% (1/36). Among the CAs presenting to the emergency department, the survival rates were higher for working hours than for non-working hours (OR: 37.6 (2.62-539.7), p: 008). The rate of return of spontaneous circulation within working hours was higher than that of non-working hours (71% vs.19%) (p<0.001). Patients who received chest compression for more than 10 minutes had the lowest survival rate (2%) (p<0.001), whereas better outcome was associated with in-hospital CA, younger age (less than 12 months) and respiratory failure.

Conclusion: Survival rates from pediatric CAs were significantly lower during non-working hours. Poor outcome was associated with prolonged cardiopulmonary resuscitation, out of hospital CA and older age.

doi: https://doi.org/10.12669/pjms.35.5.487

How to cite this:
Yurtseven A, Turan C, Akarca FK, Saz EU. Pediatric cardiac arrest in the emergency department: Outcome is related to the time of admission. Pak J Med Sci. 2019;35(5):1434-1440. doi: https://doi.org/10.12669/pjms.35.5.487

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2019-08-22
Section
Original Articles