More children surviving heart attacks in hospital

Dec 24 2012

By Sarah Guy, medwireNews Reporter

Approximately three times more children survived in-hospital cardiac arrest in 2009 compared with 2000, indicate data from the Get With The Guidelines-Resuscitation registry.

Furthermore, the improved survival rates were not accompanied by an increase in rates of significant neurologic disability.

The findings emerge despite an increase in this population in the number of cardiac arrests resulting from nonshockable rhythms, note the researchers in Circulation: Cardiovascular Quality and Outcomes.

"Our results highlight the substantial progress that has occurred in pediatric resuscitation care in hospitals over the past decade," remark Saket Girotra (University of Iowa Hospitals, Iowa City, USA) and co-investigators.

The study population included 1031 pediatric patients aged 18 years and under who experienced cardiac arrest while an inpatient at one of 12 hospitals.

Data revealed a greater proportion of arrests due to pulseless electrical activity (PEA) in later years, rising from 26.6% in 2000-2003 to 70.3% in 2007-2009, with an overall PEA or asystole rate of 84.8% throughout the study period. The remaining 15.2% of initial cardiac arrest rhythms were ventricular fibrillation or pulseless ventricular tachycardia.

A total of 34.8% of children survived to hospital discharge, and after adjustment for patient characteristics, overall survival-to-discharge rates improved significantly over the study period - specifically, from 14.3% in 2000 to 43.4% in 2009, giving a 1.08-fold increased chance for survival per year.

The researchers observed a significant improvement in acute resuscitation survival rates, which increased from 42.9% in 2000 to 81.2% in 2009. Rates of postresuscitation survival also improved, but nonsignificantly.

Of the 83% of patients with available data, rates of neurologic disability did not change between 2000 and 2009, report Girotra et al.

A number of factors may have played a role in achieving these observed trends, notes the team, including greater vigilance and closer monitoring.

"Once identified.. best practices can be disseminated to all hospitals and measured to ensure that they lead to improved resuscitation outcomes," conclude the authors.

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