Abstract 145: Cardiopulmonary Resuscitation in Hospitalized Infants
Background: Hospitalized infants requiring cardiopulmonary resuscitation (CPR) represent a high risk group. Risk factors and outcomes are incompletely described in this population.
Methods: Retrospective cohort study of all infants receiving CPR between day of life 2 to 120 admitted to 348 neonatal intensive care units managed by the Pediatrix Medical Group. We collected data on demographics, interventions, center volume, and the outcome of interest (death prior to discharge). We evaluated predictors of death after CPR using multivariable logistic regression with generalizing estimating equations to account for clustering of the data by center. Covariates significantly associated with death in univariate analysis (p<0.05) were included in the model.
Results: Our cohort consisted of 2231 infants receiving CPR. Of these, 1104 (50%) died before hospital discharge. In adjusted analysis, older gestational age, higher 5 minute APGAR, older postnatal age, and the presence of a central venous line at the time of CPR where associated with lower mortality, while congenital anomaly, and markers of severity of illness were associated with higher mortality (Table). Mortality after CPR decreased over the duration of our study (57% in 1998-2001 vs. 50% in 2009-2012, p<0.001).
Conclusions: Mortality following CPR in infants is high particularly for those with congenital anomalies, younger gestational and postnatal age, lower 5 minute APGAR scores, and higher severity of illness. While outcomes following CPR have improved over time, there is a need to identify interventions to improve high risk subgroups including those with congenital anomalies.
Author Disclosures: C.P. Hornik: None. K.D. Hill: None. J. Li: None. G. Ofori-Amanfo: None. R.H. Clark: None. P. Smith: None.
- © 2014 by American Heart Association, Inc.