title: Incidence, causes, and outcomes of out-of-hospital cardiac arrest in children. A comprehensive, prospective, population-based study in the Netherlands.
abstract: OBJECTIVE
  This study sought to determine comprehensively the incidence of pediatric out-of-hospital cardiac arrest (OHCA) and its contribution to total pediatric mortality, the causes of pediatric OHCA, and the outcome of resuscitation of pediatric OHCA patients.
  
  
  BACKGROUND
  There is a paucity of complete studies on incidence, causes, and outcomes of pediatric OHCA.
  
  
  METHODS
  In this prospective, population-based study, OHCA victims younger than age 21 years in 1 province of the Netherlands were registered through both emergency medical services and coroners over a period of 4.3 years. Death certificate data on total pediatric mortality, survival status, and neurological outcome at hospital discharge also were obtained.
  
  
  RESULTS
  With a total mortality of 923 during the study period and 233 victims of OHCA (including 221 who died and 12 who survived), OHCA caused 24% (221 of 923) of total pediatric mortality. Natural causes of OHCA amounted to 115 (49%) cases, with cardiac causes being most prevalent (n = 90, 39%). The incidence of pediatric OHCA was 9.0 per 100,000 pediatric person-years (95% confidence interval: 7.8 to 10.3), whereas the incidence of pediatric OHCA from cardiac causes was 3.2 (95% confidence interval: 2.5 to 3.9). Of 51 resuscitated patients, 12 (24%) survived; among survivors, 10 (83%) had a neurologically intact outcome.
  
  
  CONCLUSIONS
  Out-of-hospital cardiac arrest accounts for a significant proportion of pediatric mortality, and cardiac causes are the most prevalent causes of OHCA. The vast majority of OHCA survivors have a neurologically intact outcome.
authors.affiliation: Heart Failure Research Center, Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
authors.forename: Abdennasser
authors.initials: A
authors.lastname: Bardai
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Berdowski
authors.forename: Christian
authors.initials: C
authors.lastname: van der Werf
authors.forename: Marieke T
authors.initials: MT
authors.lastname: Blom
authors.forename: Manon
authors.initials: M
authors.lastname: Ceelen
authors.forename: Irene M
authors.initials: IM
authors.lastname: van Langen
authors.forename: Jan G P
authors.initials: JG
authors.lastname: Tijssen
authors.forename: Arthur A M
authors.initials: AA
authors.lastname: Wilde
authors.forename: Rudolph W
authors.initials: RW
authors.lastname: Koster
authors.forename: Hanno L
authors.initials: HL
authors.lastname: Tan
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D017677:Age Distribution; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D019992:Databases as Topic; D003644:Death Certificates; D047548:Defibrillators; D004632:Emergency Medical Services; D015444:Exercise; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D017678:Sex Distribution; D013177:Sports; D017180:Tachycardia, Ventricular / Q000453:epidemiology; D014693:Ventricular Fibrillation / Q000453:epidemiology; D055815:Young Adult