title: Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan.
abstract: OBJECTIVE
  To better understand and predict clinical outcomes of paediatric out-of-hospital cardiac arrest (OHCA).
  
  
  METHODS
  A population-based, observational study.
  
  
  METHODS
  The National Japan Utstein Registry.
  
  
  METHODS
  2900 children aged 5-17 years who experienced OHCA and received resuscitation by emergency responders. Signal detection analysis using 17 variables was applied to identify factors associated with OHCA outcomes; the primary endpoint was cerebral performance category (CPC) 1 or 2. A validation study was conducted to verify the model.
  
  
  RESULTS
  OHCA was identified as cardiac origin in 706 participants and non-cardiac origin in 2194 participants. Rates of CPC 1 or 2 for cardiac and non-cardiac causes were 20% and 6.4%, respectively. Cardiac origin arrest was categorised following signal detection into six subgroups defined by public automated external defibrillator use, defibrillation by emergency medical service, age, initial ECG rhythm and eye-witness to arrest; the ranges of CPC 1 or 2 in the six subgroups were between 87.5% and 0.7%. Non-cardiac origin arrest was categorised into four subgroups. Bystander rescue breathing was the most significant factor contributing to outcome; additionally, two other factors-eye-witness to arrest and age-were also significant. CPC 1 or 2 rates ranged between 38.5% and 4% across the four subgroups. Rates of CPC 1 or 2 in the validation study did not differ among any subgroup.
  
  
  CONCLUSIONS
  For children who have OHCA from non-cardiac origin, bystander rescue breathing is mandatory to achieve CPC 1 or 2.
authors: Faculty of Medical Sciences, Department of Advanced Medical Initiatives, Kyushu University, Fukuoka, Japan.
authors: Takashi
authors: T
authors: Nagata
authors: Takeru
authors: T
authors: Abe
authors: Eiichiro
authors: E
authors: Noda
authors: Manabu
authors: M
authors: Hasegawa
authors: Makoto
authors: M
authors: Hashizume
authors: Akihito
authors: A
authors: Hagihara
mesh_terms: D000293:Adolescent; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology / Q000628:therapy*; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome
keywords: Accident & Emergency Medicine; Epidemiology