Cardiac arrest in children preceding PICU admission: Aetiology and outcome in a developing country

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dc.contributor.advisorArgent, Andrewen_ZA
dc.contributor.advisorSalie, Shamielen_ZA
dc.contributor.authorAppiah, John Adabieen_ZA
dc.date.accessioned2016-01-19T12:15:43Z
dc.date.available2016-01-19T12:15:43Z
dc.date.issued2015en_ZA
dc.descriptionIncludes bibliographical referencesen_ZA
dc.description.abstractObjective: To describe the characteristics and outcomes of children admitted to PICU following cardiac arrest between January 2010 and December 2011. Methods: Retrospective descriptive study of routinely collected data. Results: Of 2501 PICU admissions, 110 (4.4%; 58.7% male) had preceding cardiac arrest, 80.6% of which occurred in hospital. Median (IQR) age was 7.2 (2.5 - 21.6) months; 30.8% had chronic underlying disease. Children presented most commonly with respiratory (n=28, 27.2%), cardiovascular (n= 22, 21.4%), and gastrointestinal disease (n= 20, 19.4%). Twenty-eight (27.2%) arrested while undergoing a procedure. Cardiopulmonary resuscitation (CPR) was given for median (IQR) 10 (5 - 20) minutes. Thirty-five (34%) patients received no adrenaline, 44 (42.7%) received up to 3 doses of adrenaline, and 24 (23.3%) received more than 3 doses of adrenaline during resuscitation. Duration of CPR and number of adrenaline doses did not significantly influence patient outcome. Survival to PICU discharge was 63 (61.2%), 57 (55.3%) survived to hospital discharge with half the deaths in PICU occurred within 24 hours of PICU admission. Out of 51 survivors whose neurological status were assessed 32 were normal, 6 had mild disability, 7 had moderate disability and 6 had severe disability. Standardized mortality ratio (actual/mean predicted) was 0.7. The median (IQR) length of stay in PICU and hospital were 3 (1 - 8) and 27 (9 -52) days respectively. Pediatric risk of mortality (PIM2) score was the only variable independently associated with mortality on multiple logistic regression (adjusted OR 1.05; 95% CI 1.02 - 1.07; p=0.0009).en_ZA
dc.identifier.apacitationAppiah, J. A. (2015). <i>Cardiac arrest in children preceding PICU admission: Aetiology and outcome in a developing country</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/16433en_ZA
dc.identifier.chicagocitationAppiah, John Adabie. <i>"Cardiac arrest in children preceding PICU admission: Aetiology and outcome in a developing country."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2015. http://hdl.handle.net/11427/16433en_ZA
dc.identifier.citationAppiah, J. 2015. Cardiac arrest in children preceding PICU admission: Aetiology and outcome in a developing country. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Appiah, John Adabie AB - Objective: To describe the characteristics and outcomes of children admitted to PICU following cardiac arrest between January 2010 and December 2011. Methods: Retrospective descriptive study of routinely collected data. Results: Of 2501 PICU admissions, 110 (4.4%; 58.7% male) had preceding cardiac arrest, 80.6% of which occurred in hospital. Median (IQR) age was 7.2 (2.5 - 21.6) months; 30.8% had chronic underlying disease. Children presented most commonly with respiratory (n=28, 27.2%), cardiovascular (n= 22, 21.4%), and gastrointestinal disease (n= 20, 19.4%). Twenty-eight (27.2%) arrested while undergoing a procedure. Cardiopulmonary resuscitation (CPR) was given for median (IQR) 10 (5 - 20) minutes. Thirty-five (34%) patients received no adrenaline, 44 (42.7%) received up to 3 doses of adrenaline, and 24 (23.3%) received more than 3 doses of adrenaline during resuscitation. Duration of CPR and number of adrenaline doses did not significantly influence patient outcome. Survival to PICU discharge was 63 (61.2%), 57 (55.3%) survived to hospital discharge with half the deaths in PICU occurred within 24 hours of PICU admission. Out of 51 survivors whose neurological status were assessed 32 were normal, 6 had mild disability, 7 had moderate disability and 6 had severe disability. Standardized mortality ratio (actual/mean predicted) was 0.7. The median (IQR) length of stay in PICU and hospital were 3 (1 - 8) and 27 (9 -52) days respectively. Pediatric risk of mortality (PIM2) score was the only variable independently associated with mortality on multiple logistic regression (adjusted OR 1.05; 95% CI 1.02 - 1.07; p=0.0009). DA - 2015 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Cardiac arrest in children preceding PICU admission: Aetiology and outcome in a developing country TI - Cardiac arrest in children preceding PICU admission: Aetiology and outcome in a developing country UR - http://hdl.handle.net/11427/16433 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16433
dc.identifier.vancouvercitationAppiah JA. Cardiac arrest in children preceding PICU admission: Aetiology and outcome in a developing country. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2015 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/16433en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Paediatrics and Child Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherCritical Care Paediatricsen_ZA
dc.titleCardiac arrest in children preceding PICU admission: Aetiology and outcome in a developing countryen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPhilen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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