Neurologic Outcomes For Pediatric Trauma Patients Who Require Cardiopulmonary Resuscitation In The Trauma Bay
Ryan Eaton1, Sarah Durisek1, *Lee Ann Wurster2, *Morgan Wurtz2, *Eric A Sribnick2
1The Ohio State University, Columbus, OH;2Nationwide Children's Hospital, Columbus, OH
Background (issue): Traumatic injury is a leading cause of morbidity and mortality in pediatric patients. Patients with severe trauma who require cardiopulmonary resuscitation (CPR) have an especially poor prognosis. Our understanding of long-term neurologic outcomes in this patient population is limited. The purpose of our study is to characterize outcomes for pediatric patients with severe trauma who require cardiopulmonary resuscitation during initial evaluation at our trauma center.
Methods: This is a single-center retrospective study of patients presenting to our level-1 pediatric trauma center who required CPR on initial evaluation in the emergency department (ED) trauma bay. Data were obtained from a trauma registry and electronic medical record.
Findings: A total of 67 patients met inclusion criteria. 31 survived initial resuscitation. Of the 31 patients admitted, 5 survived to discharge. Patients who died in the ED were more likely to receive chest compressions for a longer period of time (20 versus 8 minutes, p=0.010), and survivors tended to have a longer ED length of stay (65 versus 21 minutes p<0.001). At follow-up, one patient had no disability, two patients had mild to moderate disability, one patient had severe disability, and one patient subsequently died after hospital readmission.
Conclusions (implications for practice): In our single-center retrospective analysis, patients who required CPR on initial in-hospital resuscitation had a high mortality rate in the trauma bay and after admission. Most survivors had at least some level of neurological disability. Larger studies may be warranted to better prognosticate outcome and to create recommendations for treatment of this challenging patient population.
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