Abstract 132: General Ward Cardiopulmonary Resuscitation Events Are Becoming Near "Never Events": A Report from the Get With The Guidelines--Resuscitation Registry
Introduction: The aim of this study was to evaluate whether the proportion of pediatric in-hospital CPR events occurring in intensive care units (ICUs) compared to general wards has increased over the last decade using a large national registry database.
Hypothesis: The proportion of pediatric CPR provided in ICUs vs. general wards has increased over the past decade and this shift is associated with improved survival.
Methods: We evaluated pediatric subjects < 18 years of age with a ward or ICU CPR event between January 1, 2000 and December 31, 2010 within the Get with the Guidelines - Resuscitation (GWTG-R) database. CPR events were defined as any event treated with external chest compressions. The primary outcome was proportion of total ICU vs. general ward CPR events (index and subsequent) over time evaluated via chi square test for trend. Secondary outcomes included Utstein recommended survival outcomes.
Results: There were 5870 pediatric CPR events in the GWTG-R database between 2000-2010, of which 5477 (93.3%) occurred in ICUs compared to 393 (6.7%) on inpatient wards. Over time, significantly more of these CPR events occurred in the ICU compared to the wards (test for trend: p<0.01), with a prominent shift noted between 2003 and 2004 (2000-2003: 87 - 91% vs. 2004-2010: 94 - 96%; Figure 1). In a multivariable model controlling for within center variability and other potential confounders, compared to index events occurring between 2000-2003, patient survival to hospital discharge improved (RR 1.10, CI95 1.02 - 1.19) between 2004-2010.
Conclusions: The proportion of pediatric CPR provided in the ICU vs. inpatient wards has increased significantly over the past decade. Survival to hospital discharge for index pediatric in-hospital CPR events increased concomitantly with the shift to the ICU.
- © 2012 by American Heart Association, Inc.