Social factors affect pediatric cardiac arrest outcomes

The odds on whether a child survives a cardiac arrest may depend on where they live, according to a new study from the University of Missouri School of Medicine.

This study found that certain social factors that influence health are associated with lower odds of children receiving CPR, application of automated external defibrillators (AEDs) and surviving after experiencing a cardiac arrest. These factors include socioeconomic or poverty status, education level and minority racial makeup.

“This may be due in part to a lack of education on how to administer CPR and AED,” said emergency pediatrics doctor and study author Dr. Mary Bernardin. “The areas with highest educational attainment had the highest odds of performing CPR and using AEDs.”

While several studies show that social factors affect care for adults experiencing cardiac arrests, few focused on children and had small data groups. This study is the largest of its kind, having analyzed 21,137 data entries across 54 states and territories in the United States.

Bystanders performed CPR on children in about 62% of cases and used AEDs in about 23% of cases. Only 21% of children survived, and survival was lowest in communities with lower education levels, higher rates of poverty and high racial or ethnic minority prevalence.

The most common cause for a pediatric cardiac arrest involved an acute, traumatic event. When discussing factors that impact patient outcomes, Bernadin says it is imperative to address firearm injuries, which is the most common cause of death among children in the United States.

“Children of racial or ethnic minorities have suffered the majority of firearm injuries for decades,” Bernardin said. “Implementing interventions or community prevention of gun violence could save the lives of children most at risk.”

In addition, building educational programs may help those most at risk of seeing or experiencing a pediatric cardiac arrest. These programs would offer CPR and AED training as well as targeted interventions.

Dr. Mary Bernardin is an assistant professor of emergency medicine and pediatrics at the MU School of Medicine and a pediatric emergency medicine doctor at MU Health Care. She is the medical director of Emergency Medical Services for Children, the assistant medical director of Pediatric Emergency Medicine, and the director of Pediatric Emergency Medicine Education.

“Social determinants of health and their associations with outcomes in pediatric out-of-hospital cardiac arrest: A national study of the NEMSIS database” was recently published in Resuscitation Plus, a journal by Elsevier. In addition to Bernardin, MU study authors include Elizabeth Kendrick, manager of research activities; Danielle Lee, project support coordinator; and data analyst Paul Schuler. Jyoti Arora, Joseph Finney and Benjamin Fisher also contributed.