title: Survival After Out-of-Hospital Cardiac Arrest in Children.
abstract: BACKGROUND
  Little is known about survival after out-of-hospital cardiac arrest (OHCA) in children. We examined whether OHCA survival in children differs by age, sex, and race, as well as recent survival trends.
  
  
  RESULTS
  Within the prospective Cardiac Arrest Registry to Enhance Survival (CARES), we identified children (age <18 years) with an OHCA from October 2005 to December 2013. Survival to hospital discharge by age (categorized as infants [0 to 1 year], younger children [2 to 7 years], older children [8 to 12 years], and teenagers [13 to 17 years]), sex, and race was assessed using modified Poisson regression. Additionally, we assessed whether survival has improved over 3 time periods: 2005-2007, 2008-2010, and 2011-2013. Of 1980 children with an OHCA, 429 (21.7%) were infants, 952 (48.1%) younger children, 276 (13.9%) older children, and 323 (16.3%) teenagers. Fifty-nine percent of the study population was male and 31.8% of black race. Overall, 162 (8.2%) children survived to hospital discharge. After multivariable adjustment, infants (rate ratio: 0.56; 95% CI: 0.35, 0.90) and younger children (rate ratio: 0.42; 95% CI: 0.27, 0.65) were less likely to survive compared with teenagers. In contrast, there were no differences in survival by sex or race. Finally, there were no temporal trends in survival across the study periods (P=0.21).
  
  
  CONCLUSIONS
  In a large, national registry, we found no evidence for racial or sex differences in survival among children with OHCA, but survival was lower in younger age groups. Unlike in adults with OHCA, survival rates in children have not improved in recent years.
authors.affiliation: Children's Mercy Hospitals and Clinics, Kansas City, MO (N.J.) Saint Luke's Mid America Heart Institute, Kansas City, MO (N.J., F.T., P.S.C.).
authors.forename: Natalie
authors.initials: N
authors.lastname: Jayaram
authors.affiliation: Emory University School of Medicine, Atlanta, GA (B.M.N.) Rollins School of Public Health, Atlanta, GA (B.M.N.).
authors.forename: Bryan
authors.initials: B
authors.lastname: McNally
authors.affiliation: Saint Luke's Mid America Heart Institute, Kansas City, MO (N.J., F.T., P.S.C.).
authors.forename: Fengming
authors.initials: F
authors.lastname: Tang
authors.affiliation: Saint Luke's Mid America Heart Institute, Kansas City, MO (N.J., F.T., P.S.C.).
authors.forename: Paul S
authors.initials: PS
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016009:Chi-Square Distribution; D002648:Child; D046688:Child Mortality; D002675:Child, Preschool; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D058687:Out-of-Hospital Cardiac Arrest / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000628:therapy*; D010351:Patient Discharge; D011446:Prospective Studies; D044469:Racial Groups; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: heart arrest; pediatrics; survival