title: Improving Survival and Neurologic Function for Younger Age Groups After Out-of-Hospital Cardiac Arrest in Sweden: A 20-Year Comparison.
abstract: OBJECTIVE
  To describe changes in the epidemiology of out-of-hospital cardiac arrest in Sweden with the emphasis on the younger age groups.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Sweden.
  
  
  METHODS
  Patients were recruited from the Swedish Registry of Cardiopulmonary Resuscitation from 1990 to 2012. Only non-crew-witnessed cases were included.
  
  
  METHODS
  Cardiopulmonary resuscitation.
  
  
  RESULTS
  The endpoint was 30-day survival. Cerebral function among survivors was estimated according to the cerebral performance category scores. In all, 50,879 patients in the survey had an out-of-hospital cardiac arrest, of which 1,321 (2.6%) were 21 years old or younger and 1,543 (3.0%) were 22-35 years old. On the basis of results from 2011 and 2012, we estimated that there are 4.9 cases per 100,000 person-years in the age group 0-21 years. The highest survival was found in the 13- to 21-year age group (12.6%). Among patients 21 years old or younger, the following were associated with an increased chance of survival: increasing age, male gender, witnessed out-of-hospital cardiac arrest, ventricular fibrillation, and a short emergency medical service response time. Among patients 21 years old or younger , there was an increase in survival from 6.2% in 1992-1998 to 14.0% in 2007-2012. Among 30-day survivors, 91% had a cerebral performance category score of 1 or 2 (good cerebral performance or moderate cerebral disability) at hospital discharge.
  
  
  CONCLUSIONS
  In Sweden, among patients 21 years old or younger, five out-of-hospital cardiac arrests per 100,000 person-years occur and survival in this patient group has more than doubled during the past two decades. The majority of survivors have good or relatively good cerebral function.
authors.affiliation: 1Department of Pediatric Anesthesia and Intensive Care, Skane University Hospital, Lund University, Lund, Sweden. 2Institute of Medicine, Solna, Karolinska Institutet, School of Health and Social Sciences, University of Dalarna, Falun, Sweden. 3Department of Education, Section of Cardiology, Department of Clinical Science and Education, Karolinska Institute, South Hospital, Stockholm, Sweden. 4Department of Pediatric Anesthesia and Intensive Care, Karolinska University Hospital, Astrid Lindgrens Childrens Hospital, Stockholm, Sweden. 5Department of Caring Science, The Centre of Pre-hospital Research in Western Sweden, University College of Borås, Borås, Sweden. 6Department of Medicine and Molecular Biology, Institute of Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Gelberg
authors.forename: Anneli
authors.initials: A
authors.lastname: Strömsöe
authors.forename: Jacob
authors.initials: J
authors.lastname: Hollenberg
authors.forename: Peter
authors.initials: P
authors.lastname: Radell
authors.forename: Andreas
authors.initials: A
authors.lastname: Claesson
authors.forename: Leif
authors.initials: L
authors.lastname: Svensson
authors.forename: Johan
authors.initials: J
authors.lastname: Herlitz
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy*; D011446:Prospective Studies; D012737:Sex Factors; D013548:Sweden; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000453:epidemiology; D055815:Young Adult