What question did this study set out to answer?

This study aims to characterize children experiencing intraoperative cardiac arrest during non-cardiac surgery and identify mortality risk factors.

March 26, 2026

1364: Pediatric Intraoperative Cardiac Arrest: Aha Get With the Guidelines-Resuscitation Registry Data

Key Result

Pediatric intraoperative cardiac arrest during non-cardiac surgery resulted in 40% in-hospital mortality, with trauma (OR 10.82) and pulselessness (OR 7.68) significantly increasing mortality risk.

Key Points

This study aims to characterize children experiencing intraoperative cardiac arrest during non-cardiac surgery and identify mortality risk factors.
Retrospective multicenter cohort study
Utilized AHA Get With the Guidelines-Resuscitation registry
Analyzed data from children under 18 years old
Conducted univariate logistic regression analysis
Calculated odds ratios and confidence intervals
804 intraoperative cardiac arrest events recorded
40% resulted in in-hospital mortality
Younger age groups had lower odds of mortality compared to adolescents
Trauma patients showed significantly increased mortality odds
Pulselessness at initiation of resuscitation significantly raises mortality odds

Structured PICO

Population

804 children (< 18 years) who experienced cardiac arrest in the operating room during non-cardiac surgery between 2000 and 2023, median age 24 months.

Outcome

In-hospital mortalityhard clinical

Pediatric intraoperative cardiac arrest during non-cardiac surgery has a 40% in-hospital mortality rate, with trauma and pulselessness identified as significant risk factors for death.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Introduction: Intraoperative cardiac arrest (CA) is a rare but high-risk event in the pediatric operating room. The aim of this study was to determine characteristics of children who experience CA during non-cardiac surgery and examine risk factors for mortality after these events. Methods: We conducted a retrospective multicenter cohort study using the American Heart Association Get With the Guidelines-Resuscitation registry to identify children (12 years): OR 0.53 (95% CI 0.29-0.97), OR 0.17 (95% CI 0.11-0.27), OR 0.37 (95% CI 0.25-0.53), respectively. Among illness categories, trauma was associated with significantly increased odds of mortality compared to other noncardiac surgical patients (OR 10.82, 95% CI 6.81-17.84). Those who were pulseless on initiation of cardiopulmonary resuscitation or who started with a pulse but progressed to pulselessness had significantly increased odds of mortality compared to those who were never pulseless (OR 7.68, 95% CI 5.32-11.29 and OR 4.92, 95% CI 2.96-8.23, respectively). Use of extracorporeal cardiopulmonary resuscitation was not significantly associated with mortality (OR 1.57, 95% CI 0.76-3.32). Each subsequent year included in the analysis was associated with a 4% reduction in odds of mortality (OR 0.96, 95% CI 0.93-0.98). Conclusions: In-hospital mortality following pediatric intraoperative CA in this registry study was 40%, lower than general in-hospital CA in children. Younger age was associated with decreased odds of in-hospital mortality, while trauma and pulselessness were associated with higher odds of mortality. Further analysis is needed to better understand potential contributors to these findings.

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