Risk factors and outcomes of cardiac arrest in pediatric traumatic brain injury patients.

Background: Cardiac arrest (CA) in pediatric traumatic brain injury (pTBI) is associated with morbidity. Our objective is to investigate the incidence, risk factors, and outcomes for CA following pTBI.

Methods: The Kid Inpatient Database (KID) was queried for patients with pTBI. Patients who experienced CA were identified. Demographics, comorbidities, hospital course, and complications were compared between patients who developed CA and who did not. Risk factors for CA were explored using multivariate analysis.

Results: CA patients were more likely to have hypertension, hypertrophic cardiomyopathy, and heart defects (p ​< ​0.01). CA was more likely in patients with subdural bleeding, cerebral edema, herniation, coma, or mechanical ventilation (p ​< ​0.001). CA patients had higher odds of vasopressor and transfusions, tracheostomy, percutaneous endoscopic gastrotomy (p ​< ​0.001), and mortality (p ​< ​0.01). Mechanical ventilation, cerebral edema, heart, vasopressor use, and transfusions were associated with CA on multivariate analysis.

Conclusion: Risk factors for CA in pTBI patients include severity of injury and underlying cardiovascular abnormalities. CA was associated with morbidity and resource utilization in pTBI patients.