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MINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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ORIGINAL ARTICLE  


Minerva Anestesiologica 2017 June;83(6):574-81

DOI: 10.23736/S0375-9393.16.11561-5

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Epidemiology and outcomes of cardiac arrest among children with Down Syndrome: a multicenter analysis

Asif PADIYATH 1, Mallikarjuna RETTIGANTI 2, Jeffrey M. GOSSETT 2, Sachin D. TADPHALE 1, Xiomara GARCIA 1, Paul M. SEIB 1, Punkaj GUPTA 1

1 Division of Pediatric Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA; 2 Section of Biostatistics, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA


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BACKGROUND: With the increasing prevalence of Down Syndrome, it is unknown if children with Down Syndrome are associated with increased incidence of cardiac arrest and poor outcomes after cardiac arrest. The objective of this study was to evaluate the epidemiology of cardiac arrest and mortality after cardiac arrest among critically ill children with and without Down Syndrome.
METHODS: Patients ≤18 years admitted at a Pediatric Health Information Systems (PHIS) participating Intensive Care Unit were included (2004-2014). Multivariable logistic regression models were fitted to evaluate association of Down Syndrome with study outcomes after adjusting for patient and center characteristics.
RESULTS: A total of 849,250 patients from 44 centers were included. Of the 25,143 patients with Down Syndrome, cardiac arrest was noted among 568 (2.3%) patients with an associated mortality at hospital discharge of 248 (43.6%) patients. In contrast, of the 824,107 patients without Down Syndrome, cardiac arrest was noted among 15,822 (1.9%) patients with an associated mortality at hospital discharge of 7775 (49.1%) patients. In adjusted models, patients with Down Syndrome had a higher likelihood of having cardiac arrest as compared to patients without Down Syndrome (with vs. without Down, OR: 1.14, 95% CI: 1.03-1.25, P=0.01). Despite having a higher likelihood of cardiac arrest, patients with Down Syndrome were associated with a lower mortality after cardiac arrest (OR: 0.78, 95% CI: 0.63-0.96, P=0.02).
CONCLUSIONS: Both incidence of cardiac arrest, and mortality at hospital discharge in those with cardiac arrest vary substantially in children with and without Down Syndrome.


KEY WORDS: Down Syndrome - Mortality - Cardiopulmonary resuscitation - Pediatrics

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Publication History

Issue published online: June 7, 2017
Article first published online: December 22, 2016
Manuscript accepted: December 17, 2016
Manuscript revised: November 2, 2016
Manuscript received: July 12, 2016

Per citare questo articolo

Padiyath A, Rettiganti M, Gossett JM, Tadphale SD, Garcia X, Seib PM, et al. Epidemiology and outcomes of cardiac arrest among children with Down Syndrome: a multicenter analysis. Minerva Anestesiol 2017;83:574-81. DOI: 10.23736/S0375-9393.16.11561-5

Corresponding author e-mail

pgupta2@uams.edu