Acta Anaesthesiol Scand. 2026 Nov;70(10):e70346. doi: 10.1111/aas.70346.
ABSTRACT
BACKGROUND: National data on pediatric in-hospital cardiac arrest (pIHCA) are limited, and cohorts from highly specialized pediatric centers may not reflect the broader hospital population. We aimed to describe pIHCA reported across Swedish hospitals, with particular focus on hospitals outside the two national centers for highly specialized pediatric cardiac care.
METHODS: This retrospective observational registry study included patients aged 0-18 years with pIHCA reported to the Swedish Registry for Cardiopulmonary Resuscitation between January 1, 2005 and September 25, 2025. Cases from the two highly specialized centers were analyzed separately and as part of the complete national registry-reported cohort. The primary outcome was 30-day survival; secondary outcomes included return of spontaneous circulation (ROSC) and 1-year survival.
RESULTS: Among 525 pIHCA events, 344 occurred outside the two highly specialized centers and 181 at these centers. In the broader Swedish hospital population, 31.7% of arrests occurred on hospital wards, 26.2% in emergency departments, and 22.7% in intensive care units. CPR was initiated immediately in 81.4% of events. Forty-nine percent survived to 30 days, and 44% to 1 year. At the two highly specialized centers, infants, congenital heart disease, and arrests in intensive care units were substantially more common, and 30-day survival was 70%.
CONCLUSION: Patient characteristics, arrest location, and survival differed substantially between the broader Swedish hospital population and the two highly specialized centers. These findings highlight the heterogeneity of pIHCA across hospital settings and the importance of considering hospital type and case mix when interpreting pIHCA data.
EDITORIAL COMMENT: Pediatric patient in-hospital cardiac arrest is uncommon, though they registered in a national database in Sweden. This analysis presents 20 years of experience and follow-up for these cases describing associated factors.
PMID:42802016 | DOI:10.1111/aas.70346