• Pediatrics · Oct 2011

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

    • Masahiko Nitta, Taku Iwami, Tetsuhisa Kitamura, Vinay M Nadkarni, Robert A Berg, Naoki Shimizu, Kunio Ohta, Tatsuya Nishiuchi, Yasuyuki Hayashi, Atsushi Hiraide, Hiroshi Tamai, Masanao Kobayashi, Hiroshi Morita, and Utstein Osaka Project.
    • Department of Emergency Medicine, Osaka Medical College, Takatsuki City, Osaka 569-8686, Japan. nittam@poh.osaka-med.ac.jp
    • Pediatrics. 2011 Oct 1;128(4):e812-20.

    ObjectiveWe assessed out-of-hospital cardiac arrests (OHCAs) for various pediatric age groups.MethodsThis 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.ResultsOf 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.ConclusionSurvival and favorable neurologic outcome at 1 month were more common after pediatric OHCAs than adult OHCAs.

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