Demographics of Pediatric OHCA Survivors With Postdischarge Diseases: A National Population-Based Follow-Up Study

Abstract

Background: Postdischarge diseases (PDDs) have been reported for adult survivors of out-of-hospital cardiac arrest (OHCA). However, the detailed demographics of pediatric OHCA survivors with PDDs are not well-documented, and information regarding functional survivors is particularly limited. We aimed to report detailed information on the PDDs of survivors of traumatic and non-traumatic pediatric OHCA using a national healthcare database. Methods: We retrospectively obtained data from the Taiwan government healthcare database (2011-2015). Information on the demographics of traumatic and non-traumatic pediatric OHCA survivors (<20 years) was obtained and reported. The patients who survived to discharge (survivors) and those classified as functional survivors were followed up for 1 year for the analysis of newly diagnosed PDDs. The time from discharge to PDD diagnosis was also reported. Results: A total of 2,178 non-traumatic and 288 traumatic OHCA pediatric cases were included. Among the non-traumatic OHCA survivors (n = 374, survival rate = 17.2%), respiratory tract (n = 270, 72.2%), gastrointestinal (n = 187, 50.0%), and neurological diseases (n = 167, 49.1%) were the three most common PDD categories, and in these three categories, the majority of PDDs were atypical/influenza pneumonia, non-infective acute gastroenteritis, and generalized/status epilepsy, respectively. Among the traumatic OHCA survivors (n = 21, survival rate = 7.3%), respiratory tract diseases (n = 17, 81.0%) were the most common, followed by skin or soft tissue (n = 14, 66.7%) diseases. Most functional survivors still suffered from neurological and respiratory tract diseases. Most PDDs, except for skin or soft tissue diseases, were newly diagnosed within the first 3 months after discharge. Lee et al. Postdischarge Diseases of OHCA Survivors Conclusions: Respiratory tract (pneumonia), neurological (epilepsy), and skin or soft tissue (dermatitis) diseases were very common among both non-traumatic and traumatic OHCA survivors. More importantly, most PDDs, except for skin or soft tissue diseases, were newly diagnosed within the first 3 months after discharge.

Long-Term Outcomes after Non-Traumatic Out-of-Hospital Cardiac Arrest in Pediatric Patients: A Systematic Review

“…Mean age ranged from 1.5 to 6.4 years. Three studies were conducted in the United States of America [ 22 , 23 , 24 ], two were conducted in the Netherlands [ 25 , 26 ], one in Finland [ 27 ], and one in Taiwan [ 28 ]. Two studies were prospective cohort studies, and five were retrospective cohort studies.…”

“…Only one paper reported outcomes on post-discharge diagnosis (PDD) at 1 year post-discharge. Lee et al [ 28 ] reported that the five most common PDD types were: respiratory tract diseases (72.2%), gastrointestinal diseases (50.0%), neurological disease (49.1%), skin or soft tissue diseases (42.5%), and eye/ ear diseases (26.5%). Further, pneumonia (22.7%), acute gastroenteritis (34.8%), and epilepsy (20.6) respectively constituted the majority of respiratory, gastrointestinal, and neurological diseases.…”

“…Considering the gravity of OHCA, sequential diseases and care of the diseases should be accounted for. Lee et al [ 28 ] reported that most of the post-discharge diseases, including almost half of the neurological, urological, and cardiovascular events, were newly diagnosed within the first 3 months after discharge. Subsequently, dermatitis, the main skin problem for survivors, was more commonly diagnosed 4–6 months after discharge.…”

Out-of-Hospital Cardiac Arrest in the Paediatric Patient: An Observational Study in the Context of National Regulations

“…In addition, it may be helpful to compare local trends with the results of studies conducted in other countries. In this way, it can be assessed whether the incidences are aligned and whether the Italian emergency–urgency (E-U) system succeeds in guaranteeing, for pediatric patients, the outcome standards in terms of the probability of Return of Spontaneous Circulation (ROSC) [ 14 , 15 , 16 , 17 ]. This aspect is particularly relevant when also taking into consideration the different variables that influence outcomes for patients [ 18 , 19 , 20 ].…”