The epidemiology and outcomes of pediatric in-hospital cardiopulmonary arrest in the United States during 1997 to 2012

Objective: Evaluate the trends in the incidence of in-hospital cardiopulmonary arrest (IHCA) and the associated mortality rate in children during 1997 to 2012. Design: Retrospective cohort study using the Kids' Inpatient Database (KID). Methods: Demographic and outcome data on children under 18 years of age with and without IHCA were extracted from the KID 1997 through 2012. ICD-9 procedure codes 99.60 or 99.63 were used to define IHCA. Chi-square, Chi-square for trend, and independent Student's t-test were used to analyze the data. Results: A total of 29,577 discharges with IHCA were identified. The overall incidence of pediatric IHCA was 0.78/1000 discharges with a mortality rate of 46%. The incidence of pediatric IHCA increased significantly from 0.57 in 1997 to 1.01 in 2012 (p < 0.05). The mortality rate after IHCA decreased significantly from 51% in 1997 to 40% in 2012 (p < 0.05). The incidence of IHCA was significantly higher for males, infants, black children, children from metropolitan regions and children from lower median household income regions (p < 0.05). The mortality rate was significantly higher for teenagers, black children, Hispanic children and children from metropolitan regions (p < 0.05). Conclusion: The incidence of pediatric IHCA in the United States has increased from 1997 to 2012 while the mortality has decreased. The incidence of IHCA is higher among males, infants, black children, children from metropolitan regions and children from lower household income regions. The mortality after IHCA is higher among teenagers, black children, Hispanic children and children from metropolitan regions. (C) 2016 Elsevier Ireland Ltd. All rights reserved.