Age-specific differences in outcomes after out-of-hospital cardiac arrests

Pediatrics. 2011 Oct;128(4):e812-20. doi: 10.1542/peds.2010-3886. Epub 2011 Sep 2.

Abstract

Objective: We assessed out-of-hospital cardiac arrests (OHCAs) for various pediatric age groups.

Methods: This prospective, population-based, observational study included all emergency medical service-treated OHCAs in Osaka, Japan, between 1999 and 2006 (excluding 2004). Patients were grouped as adults (>17 years), infants (<1 year), younger children (1-4 years), older children (5-12 years), and adolescents (13-17 years). The primary outcome measure was 1-month survival with favorable neurologic outcome.

Results: Of 950 pediatric OHCAs, resuscitations were attempted for 875 patients (92%; 347 infants, 203 younger children, 135 older children, and 190 adolescents). The overall incidence of nontraumatic pediatric OHCAs was 7.3 cases per 100 000 person-years, compared with 64.7 cases per 100 000 person-years for adults and 65.5 cases per 100 000 person-years for infants. Most infant OHCAs occurred in homes (93%) and were not witnessed (90%). Adolescent OHCAs often occurred outside the home (45%), were witnessed by bystanders (37%), and had shockable rhythms (18%). One-month survival was more common after nontraumatic pediatric OHCAs than adult OHCAs (8% [56 of 740 patients] vs 5% [1677 of 33 091 patients]; adjusted odds ratio: 2.26 [95% confidence interval: 1.63-3.13]). One-month survival with favorable neurologic outcome was more common among children than adults (3% [21 of 740 patients] vs 2% [648 of 33 091 patients]; adjusted odds ratio: 2.46 [95% confidence interval: 1.45-4.18]). Rates of 1-month survival with favorable neurologic outcome were 1% for infants, 2% for younger children, 2% for older children, and 11% for adolescents.

Conclusion: Survival and favorable neurologic outcome at 1 month were more common after pediatric OHCAs than adult OHCAs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Brain Diseases / epidemiology
  • Brain Diseases / etiology*
  • Child
  • Child, Preschool
  • Coma / etiology
  • Emergency Medical Services / statistics & numerical data
  • Female
  • Humans
  • Incidence
  • Infant
  • Japan / epidemiology
  • Male
  • Neurologic Examination
  • Out-of-Hospital Cardiac Arrest* / complications
  • Out-of-Hospital Cardiac Arrest* / epidemiology
  • Out-of-Hospital Cardiac Arrest* / mortality
  • Out-of-Hospital Cardiac Arrest* / therapy
  • Prospective Studies
  • Survival Analysis
  • Trauma Severity Indices
  • Treatment Outcome
  • Young Adult