title: Out-of-hospital cardiac arrest due to drowning among children and adults from the Utstein Osaka Project.
abstract: BACKGROUND
  Children have better outcomes after out-of-hospital cardiac arrest (OHCA) than adults. However, little is known about the difference in outcomes between children and adults after OHCA due to drowning.
  
  
  OBJECTIVE
  The aim of this study is to assess the outcome after OHCA due to drowning between children and adults. Our hypothesis is that outcomes after OHCA due to drowning would be in better among children (<18 years old) compared with adults (≥18 years old).
  
  
  METHODS
  This prospective population-based, observational study included all emergency medical service-treated OHCA due to drowning in Osaka, Japan, between 1999 and 2010 (excluding 2004). Outcomes were evaluated between younger children (0-4 years old), older children (5-17 years old), and adults (≥18 years old). Major outcome measures were one-month survival and neurologically favorable one-month survival defined as cerebral performance category 1 or 2. Multivariate logistic regression analyses were used to account for potential confounders.
  
  
  RESULTS
  During the study period, 66,716 OHCAs were documented, and resuscitation was attempted for 62,048 patients (1300 children [2%] and 60,748 adults [98%]). Among these OHCAs, 1737 (3% of OHCAs) were due to drowning (36 younger children [2%], 32 older children [2%], and 1669 adults [96%]). The odds of one-month survival were significantly higher for younger children (28% [10/36]; adjusted odds ratio [AOR], 20.20 [95% confidence interval {CI} 7.45-54.78]) and older children (9% [3/32]; AOR, 4.47 [95% CI 1.04-19.27]) when compared with adults (2% [28/1669]). However, younger children (6% [2/36]; AOR, 5.23 [95% CI 0.52-51.73]) and older children (3% [1/32]; AOR, 2.53 [95% CI 0.19-34.07]) did not have a higher odds of neurologically favorable outcome than adults (1% [11/1669]).
  
  
  CONCLUSIONS
  In this large OHCA registry, children had better one-month survival rates after OHCA due to drowning compared with adults. Most survivors in all groups had unfavorable neurological outcomes.
authors.affiliation: Department of Emergency Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan; Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan. Electronic address: nittam@poh.osaka-med.ac.jp.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Nitta
authors.forename: Tetsuhisa
authors.initials: T
authors.lastname: Kitamura
authors.forename: Taku
authors.initials: T
authors.lastname: Iwami
authors.forename: Vinay M
authors.initials: VM
authors.lastname: Nadkarni
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.forename: Alexis A
authors.initials: AA
authors.lastname: Topjian
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Chika
authors.initials: C
authors.lastname: Nishiyama
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nishiuchi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Nishimoto
authors.forename: Akira
authors.initials: A
authors.lastname: Takasu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004332:Drowning / Q000401:mortality*; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015701:Near Drowning / Q000628:therapy; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D011446:Prospective Studies; D012042:Registries; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Adults; Children; Drowning; Out-of-hospital cardiac arrest