Scholarlink

Introduction <p>Outcomes of pediatric cardiac arrest in our country remain suboptimal. Understanding the factors that influence these outcomes is essential for improving survival rates. This study aimed to evaluate the clinical outcomes of pediatric cardiac arrest in the emergency department and to identify the factors associated with these outcomes.</p> Methods <p>A retrospective cohort study was conducted involving patients aged &lt; 18 years who underwent cardiopulmonary resuscitation (CPR) in the emergency department of the French Medical Institute for Mothers and Children (FMIC) in Kabul, Afghanistan, between January 2021 and January 2025. Data were collected using the Utstein style of reporting. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with survival outcomes.</p> Results <p>Of the 200 patients who underwent CPR in the ED, sustained return of spontaneous circulation (ROSC) and survival to hospital discharge (STD) were achieved in 134 (67%) and 60 (30%) patients, respectively. Favorable neurological outcomes at hospital discharge were observed in 29 (14.5%) patients. Independent predictors of ROSC included IV/IO access established prior to arrest (AOR: 3.26, 95% CI: 1.68–6.3, <i>p</i> &lt; 0.001), monitoring at the time of arrest (<i>p</i> = 0.003), administration of epinephrine during CPR (AOR: 18.3, 95% CI: 6.8–49.6, <i>p</i> &lt; 0.001), endotracheal intubation during CPR (<i>p</i> &lt; 0.001), and CPR duration ≤ 20&#xa0;min (<i>p</i> &lt; 0.001). Factors associated with survival to hospital discharge included response time ≤ 1&#xa0;min (AOR: 7.2, 95% CI: 1.9–26.4, <i>p</i> = 0.003), time to first epinephrine dose ≤ 2&#xa0;min (AOR: 5.3, 95% CI: 1.1–24.6, <i>p</i> = 0.03), administration of ≤ 2 doses of epinephrine during CPR (AOR: 5.3, 95% CI: 1.1–24.6, <i>p</i> = 0.03), CPR duration ≤ 15&#xa0;min (<i>p</i> = 0.003), and post-resuscitation vasopressor/inotrope therapy (AOR: 5.79, 95% CI: 2.6–12.6, <i>p</i> &lt; 0.001).</p> Conclusion <p>Factors associated with favorable post-cardiac arrest outcomes included monitoring at the time of arrest, response time ≤ 1&#xa0;min, endotracheal intubation during CPR, administration of ≤ 2 doses of epinephrine during CPR, and CPR duration ≤ 15&#xa0;min. Early recognition, immediate cardiac monitoring for at-risk patients, and timely high-quality CPR may significantly improve post-arrest outcomes.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Clinical outcomes of cardiac arrest in pediatric patients presenting to the emergency department of a tertiary hospital in Kabul, Afghanistan: a retrospective cohort study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月12日

查看全文
  • Mujeebullah Mahboob,
  • Shafiqullah Shahim,
  • Nijatullah Safi

摘要

Introduction

Outcomes of pediatric cardiac arrest in our country remain suboptimal. Understanding the factors that influence these outcomes is essential for improving survival rates. This study aimed to evaluate the clinical outcomes of pediatric cardiac arrest in the emergency department and to identify the factors associated with these outcomes.

Methods

A retrospective cohort study was conducted involving patients aged < 18 years who underwent cardiopulmonary resuscitation (CPR) in the emergency department of the French Medical Institute for Mothers and Children (FMIC) in Kabul, Afghanistan, between January 2021 and January 2025. Data were collected using the Utstein style of reporting. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with survival outcomes.

Results

Of the 200 patients who underwent CPR in the ED, sustained return of spontaneous circulation (ROSC) and survival to hospital discharge (STD) were achieved in 134 (67%) and 60 (30%) patients, respectively. Favorable neurological outcomes at hospital discharge were observed in 29 (14.5%) patients. Independent predictors of ROSC included IV/IO access established prior to arrest (AOR: 3.26, 95% CI: 1.68–6.3, p < 0.001), monitoring at the time of arrest (p = 0.003), administration of epinephrine during CPR (AOR: 18.3, 95% CI: 6.8–49.6, p < 0.001), endotracheal intubation during CPR (p < 0.001), and CPR duration ≤ 20 min (p < 0.001). Factors associated with survival to hospital discharge included response time ≤ 1 min (AOR: 7.2, 95% CI: 1.9–26.4, p = 0.003), time to first epinephrine dose ≤ 2 min (AOR: 5.3, 95% CI: 1.1–24.6, p = 0.03), administration of ≤ 2 doses of epinephrine during CPR (AOR: 5.3, 95% CI: 1.1–24.6, p = 0.03), CPR duration ≤ 15 min (p = 0.003), and post-resuscitation vasopressor/inotrope therapy (AOR: 5.79, 95% CI: 2.6–12.6, p < 0.001).

Conclusion

Factors associated with favorable post-cardiac arrest outcomes included monitoring at the time of arrest, response time ≤ 1 min, endotracheal intubation during CPR, administration of ≤ 2 doses of epinephrine during CPR, and CPR duration ≤ 15 min. Early recognition, immediate cardiac monitoring for at-risk patients, and timely high-quality CPR may significantly improve post-arrest outcomes.