Outcomes of Pediatric Cardiopulmonary Resuscitation: A Retrospective Cross-Sectional Study from a Single Center.

Abstract

Introduction: Cardiac arrest is defined by a lack of central pulse, unresponsiveness, and apnea, indicating the termination of effective mechanical heart activity. Although rare in pediatrics, it results in poor outcomes. Results concerning the survival rates of pediatrics after cardiopulmonary resuscitation (CPR) in Jordan are absent, making this study crucial knowledge for implication of hospital protocol.

Material/method: A retrospective study was conducted at a tertiary hospital in Jordan. This study included 411 pediatric patients, aged over one day to under 12 years, who underwent CPR either during an emergency department (ED) visit or during hospitalization. The Mann-Whitney U-test, Chi-Square test, and Fisher's exact tests were used for analysis. Survival-associated factors were analyzed using univariate and multivariate logistic regression, and p < 0.05 was considered significant.

Results: Patients were separated into a less than one year age group and a greater than one year age group, with similar gender distributions. Survival was significantly associated with age; the survivors were older than the non-survivors. Furthermore, the presence of any neurological manifestation was associated with a higher risk of mortality with an odds ratio of 3.97 (95% CI: 1.46-10.86, p = 0.007). After adjusting for all covariates, each 1% rise in oxygen saturation increased the adjusted odds ratio (AOR) of survival (AOR = 1.08, 95% CI 1.01-1.15; p = 0.031). In the same model, every additional minute of CPR sharply decreased the likelihood of survival (AOR = 0.38, 95% CI 0.21-0.72; p = 0.003).

Conclusion: The survival rates after CPR in pediatrics were poor overall, suggesting a need for better pediatric CPR strategies and further studies. Many factors could affect the outcomes, most importantly, the duration of CPR and the oxygen saturation.