Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest.
BACKGROUND
Population-based data for pediatric cardiac arrest are scant and largely from urban areas. The Resuscitation Outcomes Consortium (ROC) Epistry-Cardiac Arrest is a population-based emergency medical services registry of out-of-hospital nontraumatic cardiac arrest (OHCA). This study examined age-stratified incidence and outcomes of pediatric OHCA. We hypothesized that survival to hospital discharge is less frequent from pediatric OHCA than adult OHCA.


RESULTS
This prospective population-based cohort study in 11 US and Canadian ROC sites included persons <20 years of age who received cardiopulmonary resuscitation or defibrillation by emergency medical service providers and/or received bystander automatic external defibrillator shock or who were pulseless but received no resuscitation by emergency medical services between December 2005 and March 2007. Patients were stratified a priori into 3 age groups: <1 year (infants; n=277), 1 to 11 years (children; n=154), and 12 to 19 years (adolescents; n=193). The incidence of pediatric OHCA was 8.04 per 100 000 person-years (72.71 in infants, 3.73 in children, and 6.37 in adolescents) versus 126.52 per 100,000 person-years for adults. Survival for all pediatric OHCA was 6.4% (3.3% for infants, 9.1% for children, and 8.9% for adolescents) versus 4.5% for adults (P=0.03). Unadjusted odds ratio for pediatric survival to discharge compared with adults was 0.71 (95% confidence interval, 0.37 to 1.39) for infants, 2.11 (95% confidence interval, 1.21 to 3.66) for children, and 2.04 (95% confidence interval, 1.24 to 3.38) for adolescents.


CONCLUSIONS
This study demonstrates that the incidence of OHCA in infants approaches that observed in adults but is lower among children and adolescents. Survival to discharge was more common among children and adolescents than infants or adults.
Atkins
Dianne L
DL
University of Iowa Carver College of Medicine, University of Iowa Children's Hospital, Iowa City, IA 52242-1083, USA. dianne-atkins@uiowa.edu
Everson-Stewart
Siobhan
S
Sears
Gena K
GK
Daya
Mohamud
M
Osmond
Martin H
MH
Warden
Craig R
CR
Berg
Robert A
RA
D000293:Adolescent; D017677:Age Distribution; D016887:Cardiopulmonary Resuscitation / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D004554:Electric Countershock / Q000401:mortality*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012042:Registries; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000401:mortality / Q000628:therapy