Incidence, Causes, and Outcomes of Out-of-Hospital Cardiac Arrest in Children

• Published in: Journal of the American College of Cardiology Vol. 57; no. 18; pp. 1822 - 1828
• Main Authors: Bardai, Abdennasser, MD, Berdowski, Jocelyn, PhD, MSE, van der Werf, Christian, MD, Blom, Marieke T., MA, Ceelen, Manon, PhD, van Langen, Irene M., MD, PhD, Tijssen, Jan G.P., PhD, Wilde, Arthur A.M., MD, PhD, Koster, Rudolph W., MD, PhD, Tan, Hanno L., MD, PhD
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 03.05.2011
• Subjects: cardiopulmonary resuscitation; Cardiovascular; children; epidemiology; Internal Medicine; out-of-hospital cardiac arrest; AED; ventricular fibrillation; ICD-10; CPR; International Classification of Diseases-10th Revision; EMS; out-of-hospital cardiac arrest; emergency medical services; VF; epidemiology; automated external defibrillator; cardiopulmonary resuscitation; OHCA; ventricular tachycardia; children; VT
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2010.11.054

Objectives This study sought to determine comprehensively the incidence of pediatric out-of-hospital cardiac arrest (OHCA) and its contribution to total pediatric mortality, the causes of pediatric OHCA, and the outcome of resuscitation of pediatric OHCA patients. Background There is a paucity of complete studies on incidence, causes, and outcomes of pediatric OHCA. Methods In this prospective, population-based study, OHCA victims younger than age 21 years in 1 province of the Netherlands were registered through both emergency medical services and coroners over a period of 4.3 years. Death certificate data on total pediatric mortality, survival status, and neurological outcome at hospital discharge also were obtained. Results With a total mortality of 923 during the study period and 233 victims of OHCA (including 221 who died and 12 who survived), OHCA caused 24% (221 of 923) of total pediatric mortality. Natural causes of OHCA amounted to 115 (49%) cases, with cardiac causes being most prevalent (n = 90, 39%). The incidence of pediatric OHCA was 9.0 per 100,000 pediatric person-years (95% confidence interval: 7.8 to 10.3), whereas the incidence of pediatric OHCA from cardiac causes was 3.2 (95% confidence interval: 2.5 to 3.9). Of 51 resuscitated patients, 12 (24%) survived; among survivors, 10 (83%) had a neurologically intact outcome. Conclusions Out-of-hospital cardiac arrest accounts for a significant proportion of pediatric mortality, and cardiac causes are the most prevalent causes of OHCA. The vast majority of OHCA survivors have a neurologically intact outcome.