Abstract 411: Characterization of Pediatric In-Hospital Cardiac Arrest in Denmark

Background: Pediatric in-hospital cardiac arrest occurs frequently and is associated with high mortality. However, the epidemiology of pediatric in-hospital cardiac arrest outside of the US is poorly characterized.

Aim: We aimed to characterize pediatric in-hospital cardiac arrests in Denmark.

Methods: This is a nationwide cohort study. We collected data from the Danish in-hospital cardiac arrest registry (DANARREST) from 2013-2021. We included all pediatric in-hospital cardiac arrests (<18 years of age) with a clinical indication for CPR. Neonatal cardiac arrests were excluded.

Results: We identified 318 cases of which 137 had a cardiac arrest with an indication for CPR and complete data. Overall, the median (quartile 1; quartile 3) age was 2 (0; 13) years and 90 (66%) were male. In total, 34 (25%) occurred in the pediatric intensive care unit, 79 (58%) were monitored, 121 (90%) were witnessed, and 42 (31%) were intubated prior to the cardiac arrest. The initial rhythm was PEA (51%), asystole (19%), VF/ VT (13%) and pulse generating rhythm (17%). The cause of arrest was cardiac (23%) vs. non-cardiac (77%). Median time to first rhythm check was 1 (0;3) minutes and median time to arrival of the cardiac arrest team was 3 (2; 5) minutes. Overall, 81% achieved return of spontaneous circulation or return of circulation on ECMO, whereas 49% survived to 30 days, and 43% survived to one year.

Conclusion: Most pediatric in-hospital cardiac arrests in Denmark occurred outside of the pediatric intensive care units, and almost half were not monitored. However, almost half survived to 30 days.