Cardiac Arrest During Delivery Hospitalization
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Estimates of cardiac arrest occurring during delivery guide evidence-based strategies to reduce pregnancy-related death.
OBJECTIVE
To investigate rate of, maternal characteristics associated with, and survival after cardiac arrest during delivery hospitalization.
DESIGN
Retrospective cohort study.
SETTING
U.S. acute care hospitals, 2017 to 2019.
PARTICIPANTS
Delivery hospitalizations among women aged 12 to 55 years included in the National Inpatient Sample database.
MEASUREMENTS
Delivery hospitalizations, cardiac arrest, underlying medical conditions, obstetric outcomes, and severe maternal complications were identified using codes from the International Classification of Diseases, 10th Revision, Clinical Modification. Survival to hospital discharge was based on discharge disposition.
RESULTS
Among 10 921 784 U.S. delivery hospitalizations, the cardiac arrest rate was 13.4 per 100 000. Of the 1465 patients who had cardiac arrest, 68.6% (95% CI, 63.2% to 74.0%) survived to hospital discharge. Cardiac arrest was more common among patients who were older, were non-Hispanic Black, had Medicare or Medicaid, or had underlying medical conditions. Acute respiratory distress syndrome was the most common co-occurring diagnosis (56.0% [CI, 50.2% to 61.7%]). Among co-occurring procedures or interventions examined, mechanical ventilation was the most common (53.2% [CI, 47.5% to 59.0%]). The rate of survival to hospital discharge after cardiac arrest was lower with co-occurring disseminated intravascular coagulation (DIC) without or with transfusion (50.0% [CI, 35.8% to 64.2%] or 54.3% [CI, 39.2% to 69.5%], respectively).
LIMITATIONS
Cardiac arrests occurring outside delivery hospitalizations were not included. The temporality of arrest relative to the delivery or other maternal complications is unknown. Data do not distinguish cause of cardiac arrest, such as pregnancy-related complications or other underlying causes among pregnant women.
CONCLUSION
Cardiac arrest was observed in approximately 1 in 9000 delivery hospitalizations, among which nearly 7 in 10 women survived to hospital discharge. Survival was lowest during hospitalizations with co-occurring DIC.
Click on any of these tags to subscribe to Topic Alerts. Once subscribed, you can get a single, daily email any time PracticeUpdate publishes content on the topics that interest you.
Visit your Preferences and Settings section to Manage All Topic Alerts
Additional Info
Cardiac Arrest During Delivery Hospitalization : A Cohort Study
Ann. Intern. Med 2023 Mar 14;[EPub Ahead of Print], ND Ford, CL DeSisto, RR Galang, EV Kuklina, LS Sperling, JY KoFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.