title: Cardiac arrest in schools: Nationwide incidence, risk, and outcome.
abstract: Schools are an important location for improving OHCA outcome. But there are few data on out of hospital cardiac arrest (OHCA) in schools. This study aimed to show incidence and outcome of OHCA in schools, specifying location and activities.
  
  
  
  We used the Korean nationwide OHCA registry from 2008 to 2014. OHCA victims were categorized regarding level of school. The average annual incidence of OHCA was calculated based on per 1000 schools. The epidemiological characteristics are analysed and location and activity at the time of arrest is further described. The outcome of OHCA victims were analysed.
  
  
  
  511 OHCA occurred in school while 374 cases were cardiac origin, 125 cases were non-cardiac, and 12 cases were missing in information. Annual incidence was 5.72 per 1000 school while highest incidence was shown in university (11.02 per 1000 school). The majority of victims were male (84.1%), aged 19-64 (62.2%, median 44.75), either students (35.0%) or visitors (35.2%). Most victims had none shockable rhythms, did not received EMS defibrillation and were not witnessed arrests, while most received bystander CPR. A large proportion of arrests occurred at an outdoor campus (29.7%) or sports facility (28.8%), and the most frequent activity was exercise (30.7%). 100 patients (19.6%) survived to discharge, and 66 patients (12.9%) were discharged with good neurological outcome.
  
  
  
  Incidence of OHCA in school is low. Most of victims were adult visitors. About one third of OHCA occurred during sports activity or at the sports facility.
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: soyun.from.earth@gmail.com.
authors.forename: Soyun
authors.initials: S
authors.lastname: Hwang
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Biomedical Research Institute Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: sdshin@snu.ac.kr.
authors.forename: Sang Do
authors.initials: SD
authors.lastname: Shin
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Biomedical Research Institute Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: emkwlee@gmail.com.
authors.forename: Kyungwon
authors.initials: K
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Biomedical Research Institute Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: skciva@gmail.com.
authors.forename: Kyoung Jun
authors.initials: KJ
authors.lastname: Song
authors.affiliation: Laboratory of Emergency Medical Services, Biomedical Research Institute Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: arendt75@gmail.com.
authors.forename: Ki Ok
authors.initials: KO
authors.lastname: Ahn
authors.affiliation: Laboratory of Emergency Medical Services, Biomedical Research Institute Seoul National University Hospital, Seoul, Republic of Korea; Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: myda02@gmail.com.
authors.forename: Yu Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Laboratory of Emergency Medical Services, Biomedical Research Institute Seoul National University Hospital, Seoul, Republic of Korea; Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea. Electronic address: emkjhong@gmail.com.
authors.forename: Ki Jeong
authors.initials: KJ
authors.lastname: Hong
authors.affiliation: Laboratory of Emergency Medical Services, Biomedical Research Institute Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: Ro.youngsun@gmail.com.
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Ro
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Biomedical Research Institute Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: ironlyj@gmail.com.
authors.forename: Eui Jung
authors.initials: EJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data; D015444:Exercise; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D017063:Outcome Assessment, Health Care; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012574:Schools / Q000706:statistics & numerical data*
keywords: Cardiac arrest; Epidemiology; Outcomes; School