Predictors and outcome of cardiac arrest in paediatric patients presenting to emergency medicine department of tertiary hospitals in Tanzania
Dublin Core
Title
Predictors and outcome of cardiac arrest in paediatric patients presenting to emergency medicine department of tertiary hospitals in Tanzania
Subject
Paediatrics, Cardiac arrest, In-hospital cardiac arrest, LMIC, Emergency Department, Tanzania
Description
Background: The survival of children who sufer cardiac arrest is poor. This study aimed to determine the predictors
and outcome of cardiac arrest in paediatric patients presenting to an emergency department of a tertiary hospital in
Tanzania.
Methodology: This was a prospective cohort study of paediatric patients>1 month to≤14 years presenting to
Emergency Medicine Department of Muhimbili National Hospital (EMD) in Tanzania from September 2019 to January
2020 and triaged as Emergency and Priority. We enrolled consecutive patients during study periods where patients’
demographic and clinical presentation, emergency interventions and outcome were recorded. Logistic regression
analysis was performed to identify the predictors of cardiac arrest.
Results: We enrolled 481 patients, 294 (61.1%) were males, and the median age was 2 years [IQR 1–5 years]. Among
studied patients, 38 (7.9%) developed cardiac arrest in the EMD, of whom 84.2% were≤5 years. Referred patients
were over-represented among those who had an arrest (84.2%). The majority 33 (86.8%) of those who developed
cardiac arrest died. Compromised circulation on primary survey (OR 5.9 (95% CI 2.1–16.6)), bradycardia for age on
arrival (OR 20.0 (CI 1.6–249.3)), hyperkalemia (OR 8.2 (95% CI 1.4–47.7)), elevated lactate levels>2 mmol/L (OR 5.2 (95%
CI 1.4–19.7)), oxygen therapy requirement (OR 5.9 (95% CI 1.3–26.1)) and intubation within the EMD (OR 4.8 (95% CI
1.3–17.6)) were independent predictors of cardiac arrest.
Conclusion: Thirty-eight children developed cardiac arrest in the EMD, with a very high mortality. Those who
arrested were more likely to present with signs of hypoxia, shock and acidosis, which suggest they were at later stage
in their illness. Outcomes can be improved by strengthening the pre-referral care and providing timely critical management to prevent cardiac arrest.
and outcome of cardiac arrest in paediatric patients presenting to an emergency department of a tertiary hospital in
Tanzania.
Methodology: This was a prospective cohort study of paediatric patients>1 month to≤14 years presenting to
Emergency Medicine Department of Muhimbili National Hospital (EMD) in Tanzania from September 2019 to January
2020 and triaged as Emergency and Priority. We enrolled consecutive patients during study periods where patients’
demographic and clinical presentation, emergency interventions and outcome were recorded. Logistic regression
analysis was performed to identify the predictors of cardiac arrest.
Results: We enrolled 481 patients, 294 (61.1%) were males, and the median age was 2 years [IQR 1–5 years]. Among
studied patients, 38 (7.9%) developed cardiac arrest in the EMD, of whom 84.2% were≤5 years. Referred patients
were over-represented among those who had an arrest (84.2%). The majority 33 (86.8%) of those who developed
cardiac arrest died. Compromised circulation on primary survey (OR 5.9 (95% CI 2.1–16.6)), bradycardia for age on
arrival (OR 20.0 (CI 1.6–249.3)), hyperkalemia (OR 8.2 (95% CI 1.4–47.7)), elevated lactate levels>2 mmol/L (OR 5.2 (95%
CI 1.4–19.7)), oxygen therapy requirement (OR 5.9 (95% CI 1.3–26.1)) and intubation within the EMD (OR 4.8 (95% CI
1.3–17.6)) were independent predictors of cardiac arrest.
Conclusion: Thirty-eight children developed cardiac arrest in the EMD, with a very high mortality. Those who
arrested were more likely to present with signs of hypoxia, shock and acidosis, which suggest they were at later stage
in their illness. Outcomes can be improved by strengthening the pre-referral care and providing timely critical management to prevent cardiac arrest.
Creator
Amne O. Yussuf, Said S. Kilindimo, Hendry R. Sawe, Elishah N. Premji, Hussein K. Manji, Alphonce N. Simbila, Juma A. Mfnanga and Ellen J. Weber
Publisher
BMC Emergency Medicine
Date
(2022) 22:126
Contributor
Fajar Bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Amne O. Yussuf, Said S. Kilindimo, Hendry R. Sawe, Elishah N. Premji, Hussein K. Manji, Alphonce N. Simbila, Juma A. Mfnanga and Ellen J. Weber, “Predictors and outcome of cardiac arrest in paediatric patients presenting to emergency medicine department of tertiary hospitals in Tanzania,” Repository Horizon University Indonesia, accessed March 10, 2025, https://repository.horizon.ac.id/items/show/4236.