Epidemiology, Process of Care, and Associated Outcomes of Pediatric Out-of-Hospital Cardiac Arrest in China: Results From a Prospective, Multicenter, Population-Based Registry

Xiangkai Zhao; Wen Zheng; Yu Ma; Yaping Hou; Yimin Zhu; Jiaqi Zheng; Quan Wang; Chang Pan; Jianbo Zhang; Chunyi Wang; Yuan Bian; Rugang Liu; Kai Cheng; Jingjing Ma; Marcus Eng Hock Ong; Feng Xu; Yuguo Chen; Baseline Investigation of Out-of-Hospital Cardiac Arrest (BASIC-OHCA) Coordinators and Investigators

doi:10.1097/CCM.0000000000006436

Epidemiology, Process of Care, and Associated Outcomes of Pediatric Out-of-Hospital Cardiac Arrest in China: Results From a Prospective, Multicenter, Population-Based Registry

Crit Care Med. 2024 Dec 1;52(12):e604-e615. doi: 10.1097/CCM.0000000000006436. Epub 2024 Oct 7.

Authors

Xiangkai Zhao^{1

2

3}, Wen Zheng^{1

2

3}, Yu Ma⁴, Yaping Hou^{1

2

3}, Yimin Zhu⁵, Jiaqi Zheng^{1

2

3}, Quan Wang⁶, Chang Pan^{1

2

3}, Jianbo Zhang^{1

2

3}, Chunyi Wang^{1

2

3}, Yuan Bian^{1

2

3}, Rugang Liu^{1

2

3}, Kai Cheng^{1

2

3}, Jingjing Ma^{1

2

3}, Marcus Eng Hock Ong⁷, Feng Xu^{1

2

3}, Yuguo Chen^{1

2

3}; Baseline Investigation of Out-of-Hospital Cardiac Arrest (BASIC-OHCA) Coordinators and Investigators

Affiliations

¹ Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan, China.
² Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China.
³ The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital, Shandong University, Jinan, China.
⁴ Department of Intensive Care Unit, Chongqing University Central Hospital, Chongqing Key Laboratory of Emergency Medicine, Chongqing Emergency Medical Center, Chongqing, China.
⁵ Department of Emergency Medicine, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabonomics, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, China.
⁶ Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Children's Medical Center, Beijing, China.
⁷ Department of Emergency Medicine, Singapore General Hospital, Singapore.

PMID: 39637269
DOI: 10.1097/CCM.0000000000006436

Abstract

Objectives: To comprehensively describe the incidence, process of care, outcomes, and variation among different age groups of pediatric out-of-hospital cardiac arrest (OHCA) in China.

Design: The Baseline Investigation of Out-of-Hospital Cardiac Arrest (BASIC-OHCA) is a prospective, multicenter, population-based registry of emergency medical services (EMS)-assessed OHCA in China.

Setting: A total of 25 monitoring sites of all seven geographical regions were included, covering a pediatric population (age ≤ 19) of around 22.3 million in China.

Patients: Pediatric patients enrolled in BASIC-OHCA from August 2019 to December 2020 were included.

Interventions: None.

Measurements and main results: A total of 1493 pediatric patients with EMS-assessed OHCA were enrolled, and resuscitation was attempted in 651 cases (43.6%). The crude incidence of EMS-assessed and EMS-treated OHCA was 5.5 (95% CI, 5.2-5.9) and 2.4 (95% CI, 2.2-2.6) per 100,000 pediatric population. Among 651 EMS-treated OHCA cases, 434 patients (66.7%) were male, and 353 (54.2%) had nonmedical causes (trauma, asphyxia, and drowning being the most common). There were 396 patients (60.8%) who collapsed at home, and the proportion of cases that occurred in public places such as streets and schools increased with age. There were 26 patients (4.0%) who had an initial shockable rhythm. For 626 non-EMS-witnessed patients, 152 patients (24.3%) received bystander cardiopulmonary resuscitation (CPR), 68 (10.9%) received dispatcher-assisted CPR, and 3 (0.5%) had automated external defibrillator applied. The survival to discharge or 30 days was 3.5% (23/651), and the favorable neurologic prognosis was 3.1% (20/651), with no differences among age groups.

Conclusions: This study provides the first national exploration of pediatric OHCA in China. The high proportion of nonmedical causes underscores the importance of preventing accidents in children. Gaps in the chain of survival and patient outcomes provide a focus for improving the treatment of pediatric OHCA in China and other developing countries.

Publication types

Multicenter Study

MeSH terms

Adolescent
Cardiopulmonary Resuscitation* / methods
Cardiopulmonary Resuscitation* / statistics & numerical data
Child
Child, Preschool
China / epidemiology
Emergency Medical Services* / statistics & numerical data
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Out-of-Hospital Cardiac Arrest* / epidemiology
Out-of-Hospital Cardiac Arrest* / therapy
Prospective Studies
Registries*

Abstract

Publication types

MeSH terms

Grants and funding