title: Cardiopulmonary resuscitation in hospitalized infants.
abstract: Hospitalized infants requiring cardiopulmonary resuscitation (CPR) represent a high-risk group. Recent data on risk factors for mortality following CPR in this population are lacking.
  
  
  
  We hypothesized that infant demographic characteristics, diagnoses, and levels of cardiopulmonary support at the time of CPR requirement would be associated with survival to hospital discharge following CPR.
  
  
  
  Retrospective cohort study.
  
  
  
  All infants receiving CPR on day of life 2 to 120 admitted to 348 Pediatrix Medical Group neonatal intensive care units from 1997 to 2012.
  
  
  
  We collected data on demographics, interventions, center volume, and death prior to NICU discharge. We evaluated predictors of death after CPR using multivariable logistic regression with generalized estimating equations to account for clustering of the data by center.
  
  
  
  Our cohort consisted of 2231 infants receiving CPR. Of these, 1127 (51%) survived to hospital discharge. Lower gestational age, postnatal age, 5-min APGAR, congenital anomaly, and markers of severity of illness were associated with higher mortality. Mortality after CPR did not change significantly over time (Cochran-Armitage test for trend p=0.35).
  
  
  
  Mortality following CPR in infants is high, particularly for less mature, younger infants with congenital anomalies and those requiring cardiopulmonary support prior to CPR. Continued focus on at risk infants may identify targets for CPR prevention and improve outcomes.
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA. Electronic address: christoph.hornik@duke.edu.
authors.forename: Christoph P
authors.initials: CP
authors.lastname: Hornik
authors.affiliation: Medical University of South Carolina, Charleston, SC, USA. Electronic address: grahamem@musc.edu.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Graham
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA. Electronic address: kevin.hill@dm.duke.edu.
authors.forename: Kevin
authors.initials: K
authors.lastname: Hill
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA. Electronic address: li000001@mc.duke.edu.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Li
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA. Electronic address: goforiam@montefiore.org.
authors.forename: George
authors.initials: G
authors.lastname: Ofori-Amanfo
authors.affiliation: Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA. Electronic address: Reese_Clark@mednax.com.
authors.forename: Reese H
authors.initials: RH
authors.lastname: Clark
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA. Electronic address: brian.smith@duke.edu.
authors.forename: P Brian
authors.initials: PB
authors.lastname: Smith
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects* / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D007236:Infant, Small for Gestational Age / Q000502:physiology; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D015931:Intensive Care, Neonatal / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male
keywords: Cardiopulmonary resuscitation; Infants; Neonatal intensive care units; Survival