title: Epidemiology and outcome analysis of children with traumatic out-of-hospital cardiac arrest compared to nontraumatic cardiac arrest.
abstract: OBJECTIVE
  This study aimed to determine predictive factors for sustained return of spontaneous circulation (ROSC) in pediatric patients with traumatic out-of-hospital cardiac arrest (OHCA) and compared to those with nontraumatic OHCA.
  
  
  METHODS
  This was a retrospective prognostic study of children with OHCA presenting to the emergency department (ED) was conducted from 2005 to 2010. Related clinical factors that influenced sustained ROSC in traumatic OHCA patients were identified and compared to nontraumatic cases. Significant parameters in predicting sustained ROSC in traumatic OHCA children were also determined using multivariate logistic regression analysis, and etiologies of the ICU admissions were analyzed in patients with sustained ROSC.
  
  
  RESULTS
  Among 2,978 critically ill children admitted to the ED, 150 were pediatric OHCA patients, including 76 traumatic cases and 74 nontraumatic cases. Of children with OHCA, initial sustained ROSC was achieved in 51 cases (34.0 %), including 31 traumatic cases and 20 of nontraumatic cases. Head and neck injuries were the majority of traumatic cases in the traumatic OHCA children, followed by abdominal injuries and chest injuries. However, abdominal injuries accounted for the highest rate to gain sustained ROSC, while chest injuries had the lowest rate for successful sustained ROSC. Significant factors associated with sustained ROSC in traumatic OHCA included initial cardiac rhythm (P < 0.05), the period from scene to hospital (P < 0.05), and the duration of in-hospital cardiopulmonary resuscitation (CPR) (P < 0.05).
  
  
  CONCLUSIONS
  Significant factors related to sustained ROSC have been identified as initial cardiac rhythm, duration of in-hospital CPR, and the period from scene to hospital. Head and neck injuries were the majority of traumatic cases and the prevention in head and neck trauma may play an important part in public health aspects.
authors.affiliation: Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan, ROC.
authors.forename: Chun-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Yan-Ren
authors.initials: YR
authors.lastname: Lin
authors.forename: Lu-Lu
authors.initials: LL
authors.lastname: Zhao
authors.forename: Yung-Kang
authors.initials: YK
authors.lastname: Wu
authors.forename: Yu-Jun
authors.initials: YJ
authors.lastname: Chang
authors.forename: Wen-Chieh
authors.initials: WC
authors.lastname: Yang
authors.forename: Kang-Hsi
authors.initials: KH
authors.lastname: Wu
authors.forename: Han-Ping
authors.initials: HP
authors.lastname: Wu
mesh_terms: D000007:Abdominal Injuries / Q000150:complications; D016887:Cardiopulmonary Resuscitation; D002648:Child; D006259:Craniocerebral Trauma / Q000150:complications; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009104:Multiple Trauma / Q000150:complications; D019838:Neck Injuries / Q000150:complications; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology* / Q000209:etiology; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000150:complications; D014947:Wounds and Injuries / Q000150:complications*
references.citation: World J Surg. 2011 Jan;35(1):34-42
references.pmid: 20957362
references.citation: Am J Emerg Med. 2012 Oct;30(8):1630-8
references.pmid: 22633716
references.citation: Pediatr Crit Care Med. 2009 May;10(3):306-12
references.pmid: 19307806
references.citation: N Engl J Med. 1996 Nov 14;335(20):1473-9
references.pmid: 8890097
references.citation: Klin Padiatr. 2013 Jan;225(1):18-23
references.pmid: 23329622
references.citation: Resuscitation. 2012 Jan;83(1):58-62
references.pmid: 21756967
references.citation: Pediatr Surg Int. 2013 Mar;29(3):263-8
references.pmid: 23247834
references.citation: Resuscitation. 2005 Jan;64(1):37-40
references.pmid: 15629553
references.citation: Am J Emerg Med. 2010 Mar;28(3):310-7
references.pmid: 20223388
references.citation: Circulation. 2010 Nov 2;122(18 Suppl 3):S876-908
references.pmid: 20956230
references.citation: Resuscitation. 2011 Jul;82(7):830-4
references.pmid: 21497006
references.citation: J Am Coll Cardiol. 2011 May 3;57(18):1822-8
references.pmid: 21527156
references.citation: Resuscitation. 2007 Jul;74(1):83-9
references.pmid: 17353084
references.citation: Arch Dis Child. 2011 Jan;96(1):5-8
references.pmid: 20584851
references.citation: Pediatrics. 1995 Jun;95(6):901-13
references.pmid: 7761219
references.citation: Pediatr Cardiol. 2012 Mar;33(3):474-83
references.pmid: 21842254
references.citation: Ann Emerg Med. 1990 Apr;19(4):435-6
references.pmid: 2321832
references.citation: Circulation. 2009 Mar 24;119(11):1484-91
references.pmid: 19273724