title: Long-term evolution after in-hospital cardiac arrest in children: Prospective multicenter multinational study.
abstract: OBJECTIVE
  The main objective was to study survival and neurologic evolution of children who suffered in-hospital pediatric cardiac arrest (CA). The secondary objective was to analyze the influence of risk factors on the long term outcome after CA.
  
  
  METHODS
  prospective, international, observational, multicentric study in 48 hospitals of 12 countries. CA in children between 1 month and 18 years were analyzed using the Utstein template. Survival and neurological state measured by Pediatric Cerebral Performance Category (PCPC) scale one year after hospital discharge was evaluated.
  
  
  RESULTS
  502 patients with in-hospital CA were evaluated. 197 of them (39.2%) survived to hospital discharge. PCPC at hospital discharge was available in 156 of survivors (79.2%). 76.9% had good neurologic state (PCPC 1-2) and 23.1% poor PCPC values (3-6). One year after cardiac arrest we could obtain data from 144 patients (28.6%). PCPC was available in 116 patients. 88 (75.9%) had a good neurologic evaluation and 28 (24.1%) a poor one. A neurological deterioration evaluated by PCPC scale was observed in 40 patients (7.9%). One year after cardiac arrest PCPC scores compared to hospital discharge had worsen in 7 patients (6%), remained constant in 103 patients (88.8%) and had improved in 6 patients (5.2%).
  
  
  CONCLUSIONS
  Survival one year after cardiac arrest in children after in-hospital cardiac arrest is high. Neurologic outcome of these children a year after cardiac arrest is mostly the same as after hospital discharge. The factors associated with a worst long-term neurological outcome are the etiology of arrest being a traumatic or neurologic illness, and the persistency of higher lactic acid values 24h after ROSC. A standardised basic protocol even practicable for lower developed countries would be a first step for the new multicenter studies.
authors: Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón de Madrid, Medicine School, Complutense University of Madrid, Red de Salud Maternoinfantil y del Desarrollo (Red SAMID), Madrid, Spain.
authors: Jimena
authors: J
authors: Del Castillo
authors: Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón de Madrid, Medicine School, Complutense University of Madrid, Red de Salud Maternoinfantil y del Desarrollo (Red SAMID), Madrid, Spain. Electronic address: pielvi@hotmail.com.
authors: Jesús
authors: J
authors: López-Herce
authors: Pediatric Intensive Care Unit. Hospital Escuela, Tegucigalpa, Honduras.
authors: Martha
authors: M
authors: Matamoros
authors: Pediatric Intensive Care Unit. Hospital Valle de Hebroón, Barcelona, Spain.
authors: Sonia
authors: S
authors: Cañadas
authors: Pediatric Intensive Care Unit, Hospital Niño Jesús, Tucumán, Argentina.
authors: Ana
authors: A
authors: Rodríguez-Calvo
authors: Pediatric Intensive Care Unit. Ospedale Bambinu Gesu, Roma, Italy.
authors: Corrado
authors: C
authors: Cecchetti
authors: Pediatric Intensive Care Department. Hospital Clínico Universitario. Santiago de Compostela. Spain.
authors: Antonio
authors: A
authors: Rodriguez-Núñez
authors: Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón de Madrid, Medicine School, Complutense University of Madrid, Red de Salud Maternoinfantil y del Desarrollo (Red SAMID), Madrid, Spain.
authors: Angel Carrillo
authors: AC
authors: Álvarez
mesh_terms: D000293:Adolescent; D001118:Argentina / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006721:Honduras / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D010351:Patient Discharge / Q000639:trends; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiac arrest; Children; In-hospital cardiac arrest; Long-term outcome; Resuscitation