Abstract 38: Nationwide Epidemiology and Outcomes from Pediatric Out-of-Hospital Cardiac Arrest in Japan: From the JCS-ReSS Research Group
Background: Though Resuscitation Outcomes Consortium (ROC) reported large volume epidemiology from US and Canada in 2009, data for paediatric cardiac arrest is still scant. Nationwide, prospective, population-based, observational larger study has done in Japan. We reported epidemiology and outcomes from paediatric out-of-hospital cardiac arrest (OHCA) in Japan with comparison to ROC study.
Methods: Nationwide OHCA registration performed from 2005 to 2009, and gathered 547,218 cases. We enrolled 11,322 children aged less than 20 years, and were stratified into 3 age groups as same as ROC study [infants (<1 y, n 4,006), children (1-11 y, n 3,372), adolescents (12-19 y, n 3,944)]. Initial cardiac rhythms (VF/VT versus Asys/PEA), pre-hospital intervention done by emergency medical teams (EMT), and outcomes were analyzed.
Results: The incidence of paediatric OHCA in Japan was 9.81 per 100,000 person-years (74.32 in infants 5.46 in children, 8.17 in adolescents), versus 8.04 in ROC. Good neurological outcome (CPC 1 or 2) for all paediatric OHCA was 5.4% (2.9% for infants, 7.5% for children, 6.2% adolescents) versus 6.4% survival to hospital discharge in ROC. In VF/VT group showed similar trends to ROC, but in Asys/PEA group, good neurological outcome was only 1.1% versus 5% in ROC (p <0.005). Analysis of EMT intervention showed defibrillation performed in 95% for adolescents, but only 59% for children and 48% in infants despite indicated. Implementation ratio of other procedure for children was 20% for advanced airway (73% in ROC), 1.7% for resuscitation drug therapy (30% in ROC), 7.1% for IV line (42% in ROC), none for IO line (38% in ROC) in Japan.
Conclusion: This study demonstrates that the incidence of paediatric OHCA and outcome of VF/VT group are similar to previously reported epidemiology from North America. Asys/PEA group showed significantly worse outcome in Japan. It may relates to the low implementation ratio of pre-hospital intervention by EMT for children in Japan.
- © 2011 by American Heart Association, Inc.