Hospitalized Kids With CVD Who Require CPR Have Worse Outcomes

October 21, 2011

By Fran Lowry

BOSTON (Reuters Health) Oct 20 - Kids with cardiovascular disease (CVD) are more than ten times more likely to need cardiopulmonary resuscitation (CPR) in the hospital -- and much less likely to survive it -- compared to hospitalized children without heart disease, researchers said at the 2011 American Academy of Pediatrics National Conference and Exhibition.

Kids who are hospitalized with congenital heart disease were particularly at risk, according to the study.

"A significant number of children are hospitalized with congenital heart disease and other forms of cardiovascular disease at any given time; however, little is known about the risk of CPR among these groups, compared to the general population without heart disease," Dr. Adam Lowry from Baylor College of Medicine in Houston, Texas told Reuters Health. (Dr. Lowry is not related to the reporter of this story.)

To develop some population-level estimates of CPR rates and survival to hospital discharge after CPR among children with CVD, Dr. Lowry and colleagues reviewed data from the Kids' Inpatient Database (KID), a large, nationally representative database of pediatric hospitalizations for the years 2000, 2003, and 2006.

In analyzing more than 22.2 million hospitalizations, they found that children with CVD accounted for 2.2% of hospitalizations. The kids with CVD had a CPR rate of 0.74%, compared to 0.05% in kids without CVD.

The mortality rate after in-hospital CPR was 56.3% in children with CVD, vs 48.6% in children without CVD (odds ratio 1.4).

Most arrests in the CVD patients occurred with myocarditis (3.0%), heart failure (2.0%), or coronary pathology (2.0%).

CHD or structural heart disease accounted for the majority of deaths after CPR, said Dr. Lowry.

"We're hopeful that this study may prompt further investigation into disease-specific differences that may allow earlier detection of deterioration and improve survival after a CPR event," he said.

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