DOI: 10.1097/01.ccm.0000457624.29553.de

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Issn Print: 0090-3493

Publication Date: 2014/12/01


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127: IN-HOSPITAL ARRESTS, ANOXIC/HYPOXIC ISCHEMIC ENCEPHALOPATHY, AND G TUBE/TRACHEOSTOMY ESTIMATES.

Veerajalandhar Allareddy; Sankeerth Rampa; Romesh Nalliah; Karen Lidsky; Veerasathpurush Allareddy; Alexandre Rotta

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Author Information: Rainbow Babies & Children’s Hospital, Cleveland, OH

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Excerpt

Learning Objectives: Current prevalence estimates of placement of gastrostomy tube(GT) /tracheostomy in patients with anoxic/hypoxic ischemic encephalopathy injury(AHIE) post cardiopulmonary resuscitation(CPR) are unknown. Our objective is to estimate the prevalence of AHIE in hospitalized patients who had CPR and to identify patient level factors that predict the performance of GT +/- tracheostomy in those with AHIE
Methods: We performed a retrospective analysis of the Nationwide Inpatient Sample(years 2004–2010). All patients who developed AHIE following CPR were included. In this cohort the odds of having GT and tracheostomy was computed by multivariable logistic regression analysis. Patient and hospital level factors were the independent variables
Results: During the study period, a total of 686,578 hospitalizations had a CPR event. Of these, 13.7%(N=94,336) had AHIE. In the cohort of patients with AHIE, 6.8% had GT and 8.3% had tracheostomy. Patients 70yrs old or older comprised 40% of this cohort. When compared to the 40-49yrs age group, those aged >/=70yrs were associated with lower odds for GT(OR=0.65, p<0.0001). Those aged <18 yrs & those>/=60 yrs were associated with lower odds for having tracheostomy when compared to the 40-49 yrs group(p<0.0001). Each one unit increase in co-morbid burden was associated with higher odds for having GT(OR=1.19,p<0.0001) or tracheostomy(OR=1.17, p<0.0001). Blacks, Hispanics, Asians/Pacific Islanders, and Other Races were associated with higher odds for having GT or tracheostomy when compared to whites(p<0.05). Hospitals located in northeastern regions were associated with higher odds for performing GT(OR=1.48, p<0.0001) or tracheostomy (OR=1.63, p<0.0001) when compared to those in Western regions. Teaching hospitals(TH) were associated with higher odds for performing tracheostomy when compared to non-TH (OR=1.36, p<0.0001)
Conclusions: AHIE injury occurs in a significant number of in-hospital arrests requiring CPR. Certain predictors of GT/ Tracheostomy placement are identified.
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