Characteristics and outcomes of pediatric out-of-hospital cardiac arrest by scholastic age category.

Abstract

OBJECTIVES:

There is a paucity of data examining nationwide population-based incidences and outcomes of pediatric out-of-hospital cardiac arrest. The objective of this study is to describe the detailed characteristics of pediatric out-of-hospital cardiac arrest by scholastic age category and to evaluate the impact of bystander cardiopulmonary resuscitation and public access-automated external defibrillators on the 1-month survival and favorable neurological status of pediatric out-of-hospital cardiac arrest patients.

DESIGN:

A nationwide, population-based, observational study.

SETTING:

Nationwide emergency medical system in Japan.

PATIENTS:

Out-of-hospital cardiac arrest patients aged ≤ 18 yr.

MEASUREMENTS AND MAIN RESULTS:

We identified 7,624 pediatric out-of-hospital cardiac arrest patients (≤ 18 yr old) from a nationwide population-based out-of-hospital cardiac arrest database in Japan from 2005 to 2008 and stratified them into five categories by scholastic age. The overall rates of 1-month survival and favorable neurological outcomes were 11.0% and 5.1%, respectively. Bystander cardiopulmonary resuscitation resulted in a significant improvement in both 1-month survival (odds ratio 2.81; 95% confidence interval 2.30-3.44) and favorable neurological outcomes (odds ratio 4.55; 95% confidence interval 3.35-6.18). Performing public access-automated external defibrillators had a significant effect on the 1-month survival rate (odds ratio 3.51; 95% confidence interval 1.81-6.81) and favorable neurological outcomes (odds ratio 5.13; 95% confidence interval 2.64-9.96).

CONCLUSIONS:

This study demonstrated that bystander cardiopulmonary resuscitation and public access-automated external defibrillators had a significant impact on the outcomes of pediatric out-of-hospital cardiac arrest. The improved survival associated with bystander cardiopulmonary resuscitation and public access-automated external defibrillators are clinically important and are of major public health importance for school-aged out-of-hospital cardiac arrest patients.

• Authors: Manabu Akahane, Seizan Tanabe, Toshio Ogawa, Soichi Koike, Hiromasa Horiguchi, Hideo Yasunaga, Tomoaki Imamura
• Journal: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies (Pediatr Crit Care Med) Vol. 14 Issue 2 Pg. 130-6 (Feb 2013) ISSN: 1529-7535 [Print] United States
• PMID: 23314182 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Cardiopulmonary Resuscitation
• Child
• Child, Preschool
• Confidence Intervals
• Defibrillators
• Electric Countershock
• Female
• First Aid
• Humans
• Infant
• Japan
• Logistic Models
• Male
• Nervous System Diseases (etiology)
• Odds Ratio
• Out-of-Hospital Cardiac Arrest (complications, etiology, therapy)
• Survival Rate