Survival and neurological status after out-of-hospital cardiac arrest in the pediatric population in Andalusia

Objective: Little is known about the evolution and long-term neurological status of pediatric patients who survive out-of-hospital cardiac arrest. Our aim is to describe long-term survival and neurological status.

Design: Retrospective observational study, based on the Andalusian Register of out-of-hospital Cardiac Arrest.

Setting: Pre-hospital Care.

Patients: The study included patients aged 0-15 years between January 2008 and December 2012.

Interventions: Patients follow up.

Variables: Prehospital and hospital care variables were analyzed and one-year follow-up was performed, along with a specific follow-up of survivors in June 2014.

Results: Of 5069 patients included in the register, 125 (2.5%) were aged ≤15 years. Cardiac arrest was witnessed in 52.8% of cases and resuscitation was performed in 65.6%. The initial rhythm was shockable in 7 (5.2%) cases. Nearly half (48.8%) the patients reached the hospital alive, of whom 20% did so while receiving resuscitation maneuvers. Only 9 (7.2%) patients survived to hospital discharge; 5 showed ad integrum recovery and 4 showed significant neurological impairment. The 5 patients with complete recovery continued their long-term situation. The remaining 4 patients, although slight improvement, were maintained in situation of neurological disability.

Conclusions: Survival after out-of-hospital cardiac arrest in pediatric patients was low. The long-term prognosis of survivors with good neurological recovery remains, although improvement in the rest was minimal.