Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan.

ABSTRACT:

Objectives

To better understand and predict clinical outcomes of paediatric out-of-hospital cardiac arrest (OHCA).

Design

A population-based, observational study.

Setting

The National Japan Utstein Registry.

Participants

2900 children aged 5-17 years who experienced OHCA and received resuscitation by emergency responders. Signal detection analysis using 17 variables was applied to identify factors associated with OHCA outcomes; the primary endpoint was cerebral performance category (CPC) 1 or 2. A validation study was conducted to verify the model.

Results

OHCA was identified as cardiac origin in 706 participants and non-cardiac origin in 2194 participants. Rates of CPC 1 or 2 for cardiac and non-cardiac causes were 20% and 6.4%, respectively. Cardiac origin arrest was categorised following signal detection into six subgroups defined by public automated external defibrillator use, defibrillation by emergency medical service, age, initial ECG rhythm and eye-witness to arrest; the ranges of CPC 1 or 2 in the six subgroups were between 87.5% and 0.7%. Non-cardiac origin arrest was categorised into four subgroups. Bystander rescue breathing was the most significant factor contributing to outcome; additionally, two other factors-eye-witness to arrest and age-were also significant. CPC 1 or 2 rates ranged between 38.5% and 4% across the four subgroups. Rates of CPC 1 or 2 in the validation study did not differ among any subgroup.

Conclusions

For children who have OHCA from non-cardiac origin, bystander rescue breathing is mandatory to achieve CPC 1 or 2.

SUBMITTER: Nagata T 

PROVIDER: S-EPMC3927934 | biostudies-literature |

REPOSITORIES: biostudies-literature