Abstract 2014: Outcome and Characteristics of Out-of-Hospital Pediatric Cardiac Arrest from the large-scale, population-based Utstein Osaka cohort study
Objectives: To analyze the outcome and characteristics of out-of-hospital pediatric cardiac arrests from a large-scale cohort study.
Method: The Utstein Osaka project is a large population-based cohort study of out-of-hospital cardiac arrest, which covers 8.8 million residents, in Osaka, Japan. As part of this study, we evaluated emergency medical service (EMS)-treated pediatric patients (age <18 years) from January 1, 1999 to December 31, 2003, using an Utstein-style detabase. We investigated patients’ backgrounds, resuscitation characteristics, and outcomes. Data were prospectively collected by EMS personnel in cooperation with the physicians in charge of the patient.
Results: In this period, there were 650 out-of-hospital pediatric cardiac arrests and the incidence was 8.5 per 100,000 person-year. Among them, 277 cases (42.6%) were due to traumatic accidents such as traffic accidents, choking, and drowning and their survival rate was dismal (one-year neurologically favorable, 1.8%). In those with non-traumatic cardiac arrests (n=373), 45.8% were <1 year old and 56.8% were male (Table⇓). Non-cardiac etiology was more common in younger groups. The proportion of witnessed cases became smaller in younger groups and was only 12.9% in <1 year group. Bystander CPR was performed in 48.4% of cases in <1 year group while only 13–22% in other groups. Ventricular fibrillation (VF) was more common in 13–17 years group (21.8%) but there were few VF cases in the other groups. The rate of one-year neurologically favorable outcome was lower in younger age groups varied from 0.6% in <1 year group to 10.9% in 13–17 years group.
Conclusions: Traumatic arrests were common in pediatric cardiac arrest and their outcome was dismal. Outcomes from non-traumatic cardiac arrests were much better for older children whose arrests were more commonly witnessed and more frequently had VF.