title: Outcomes After Pediatric Out-of-Hospital Cardiopulmonary Interventions.
abstract: OBJECTIVE
  The aim of the study was to evaluate outcomes after pediatric out-of-hospital cardiopulmonary interventions (CPIs) by emergency medical services (EMS).
  
  
  METHODS
  Children (age, ≤18 years) who received CPI by EMS from 2001 to 2008 were identified from the Utah Department of Health. Cardiopulmonary intervention was defined as oxygenation, ventilation or CPR, and transport to a hospital by EMS. Univariate and multivariable regression analyses evaluated associations between potential predictors and outcomes (death and new neurologic dysfunction).
  
  
  RESULTS
  A total of 464 patients (58% male) received EMS attention. For the 71% patients (327) who were alive on EMS arrival, 63% (205) received CPI without CPR. Of note, 6% (12) of these patients died after arrival to the hospital and new neurologic dysfunction was diagnosed in 6% (13). Among the 12 patients who died, 50% (6) were younger than 1 year.On multivariable regression analysis, factors associated with increased risk of death before and in-hospital are the following: age younger than 1 year (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.17-0.39), shorter EMS transport time (OR, 0.94; 95% CI, 0.89-0.99), and longer EMS dispatch time (OR, 1.23; 95% CI, 1.08-1.40). Factors associated with increased risk of new neurologic dysfunction are the following: lack of pulse (OR, 0.14; 95% CI, 0.04-0.53), requiring CPR (OR, 6.15; 95% CI, 1.48-25.6), and CPR duration (OR, 1.20; 95% CI, 1.05-1.37).
  
  
  CONCLUSIONS
  Age younger than 1 year, shorter transport time, and longer dispatch time were associated with increased risk of death. Being pulseless upon discovery and receiving CPR were associated with new neurologic dysfunction. Maximizing EMS transport interventions for patients younger than 1 year requiring CPI may improve patient outcomes.
authors.forename: Jennifer Y
authors.initials: JY
authors.lastname: Lo
authors.forename: Lloyd Y
authors.initials: LY
authors.lastname: Tani
authors.forename: Miles
authors.initials: M
authors.lastname: Christensen
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Sheng
authors.forename: Jason
authors.initials: J
authors.lastname: Clawson
authors.forename: Shaji C
authors.initials: SC
authors.lastname: Menon
mesh_terms: D000293:Adolescent; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000401:mortality / Q000628:therapy*; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014589:Utah