Incidence, Etiology, and Survival Trends from Cardiovascular-related Sudden Cardiac Arrest in Children and Young Adults Ages 0-35: A 30-Year Review
Background—Sudden cardiac arrest is a leading cause of death in children and young adults. This study determined the incidence, etiology, and outcomes of cardiovascular-related out-of-hospital cardiac arrest (OHCA) in individuals less than age 35.
Methods and Results—A retrospective cohort of OHCA in children and young adults from 1980 through 2009 was identified from the King County (Washington) Division of Emergency Medical Services' Cardiac Arrest Database. Incidence was calculated using population census data and etiologies determined by review of autopsy reports and all available medical records. A total of 361 cases (26 cases ages 0-2, 30 cases ages 3-13, 60 cases ages 14-24, and 245 cases ages 25-35) of OHCA were treated by EMS responders, for an overall incidence of 2.28 per 100,000 person-years (2.1 in ages 0-2, 0.61 in ages 3-13, 1.44 in ages 14-24, and 4.40 in ages 25-35). The most common etiologies of OHCA were congenital abnormalities (84.0%) in ages 0-2 and (21%) in ages 3-13, presumed primary arrhythmia (23.5%) in ages 14-24, and coronary artery disease (42.9%) in ages 25-35. The overall survival rate was 26.9% (3.8% in ages 0-2, 40.0% in ages 3-13, 36.7% in ages 14-24, and 27.8% in ages 25-35). Survival increased throughout the study period from 13.0% in 1980-1989 to 40.2% in 2000-2009 (p<0.001).
Conclusions—The incidence of OHCA in children and young adults is higher than previously reported, and a more specific understanding of etiology should guide future prevention programs. Survival trends support contemporary resuscitation protocols for OHCA in the young.
- Received October 28, 2011.
- Accepted July 6, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited