Circulation. Cardiovascular quality and outcomes | 2019
Annual Incidence of Adult and Pediatric In-Hospital Cardiac Arrest in the United States
Abstract
BACKGROUND\nPrevious incidence estimates may no longer reflect the\ncurrent public health burden of cardiac arrest in hospitalized adult and\npediatric patients across the United States. The aim of this study was to\nestimate the contemporary annual incidence of in-hospital cardiac arrest\nin adults and children across the United States and to describe trends in\nincidence between 2008 and 2017.\n\n\nMETHODS AND RESULTS\nUsing the Get With The Guidelines–\nResuscitation registry, we developed a negative binomial regression\nmodel to estimate the incidence of index pulseless in-hospital cardiac\narrest based on hospital-level characteristics. The model was used to\npredict the number of in-hospital cardiac arrests in all US hospitals,\nusing data from the American Hospital Association Annual Survey.\nWe performed separate analyses for adult (≥18 years) and pediatric\n(<18 years) cardiac arrests. Additional analyses were performed for\nrecurrent cardiac arrests and pediatric patients requiring cardiopulmonary\nresuscitation for poor perfusion (nonpulseless events). The average\nannual incidence of in-hospital cardiac arrest in the United States was\nestimated at 292 000 (95% prediction interval, 217 600–503 500) adult\nand 15 200 pediatric cases, of which 7100 (95% prediction interval,\n4400–9900) cases were pulseless cardiac arrests and 8100 (95%\nprediction interval, 4700–11 500) cases were nonpulseless events. The\nrate of adult cardiac arrests increased over time, while pediatric events\nremained more stable. When including both index and recurrent inhospital\ncardiac arrests, the average annual incidence was estimated at\n357 900 (95% prediction interval, 247 100–598 400) adult and 19 900\npediatric cases, of which 8300 (95% prediction interval, 4900–11 200)\ncases were pulseless cardiac arrests and 11 600 (95% prediction interval,\n6400–16 700) cases were nonpulseless events.\n\n\nCONCLUSIONS\nThere are ≈292 000 adult in-hospital cardiac arrests and\n15 200 pediatric in-hospital events in the United States each year. This\nstudy provides contemporary estimates of the public health burden of\ncardiac arrest among hospitalized patients.