Epidemiology of paediatric out-of-hospital cardiac arrest in Ontario, Canada

Tijssen, Janice A.; McClean, Marisha; Lam, Melody; Le, Britney; To, Teresa

doi:10.1016/j.resplu.2023.100442

Cited by 7 publications

(6 citation statements)

References 16 publications

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“…The representativeness of the sample may be measured by the incidence of POHCA in our cohort. We calculated a crude annual incidence of 4.2 cases per 100 000 children, 21 a figure that falls within the range derived from previous studies. 1 , 3 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 …”

Section: Discussionmentioning

confidence: 75%

“…These comorbidities were selected due to their high prevalence in the case group. 21 We were unable to match for all potentially related comorbidities, due to the difficulty in finding suitable controls for conditions that are less common in the general population. The initial pool of potential controls included all children who were alive during the case accrual window.…”

Section: Methodsmentioning

confidence: 99%

“… 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 The incidence of POHCA varies regionally, with rates ranging from 2 to 18 cases per 100 000 person‐years. 1 , 3 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 Recent evidence suggests that there may be sociodemographic disparities in POHCA survival and in the provision of upstream interventions, including bystander cardiopulmonary resuscitation, automated external defibrillator application, and emergency medical services response times. 22 , 23 , 24 There is limited literature on the source of these disparities, and it is unknown whether the populations impacted also have a higher likelihood of experiencing POHCA.…”

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confidence: 99%

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Sociodemographic Factors and the Risk of Pediatric Out‐of‐Hospital Cardiac Arrest in Ontario, Canada: A Province‐Wide Case–Control Study

Idrees,

Anderson,

Choi

et al. 2024

JAHA

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Background Pediatric out‐of‐hospital cardiac arrest (POHCA) is associated with significant mortality and poor neurological outcomes. We aimed to describe the association between sociodemographic factors and POHCA risk in Ontario, Canada. Methods and Results We conducted a province‐wide case‐control study at ICES, where patient records are linked across administrative databases. The case group included children (1 day to 17 years of age) who experienced an OHCA between 2004 and 2020. Controls were matched up to 1:4 on age, sex, index date, and key comorbidities. We used conditional logistic regression to measure the association between sociodemographic indicators and POHCA risk. The case and control groups included 1,826 and 7,254 children, respectively. Children living in areas with the highest levels of material deprivation (adjusted odds ratio [aOR]: 2.35, 95% CI: 1.94, 2.85) and dependency (aOR: 1.22, 95% CI: 1.01, 1.48) had a higher odds of POHCA, relative to children living in regions with the lowest levels of material deprivation and dependency, respectively. Children living in neighborhoods with the lowest levels of ethnic diversity had a higher odds of POHCA (aOR: 1.62, 95% CI: 1.30, 2.01), relative to children living in neighborhoods with the highest levels of ethnic diversity. The odds of POHCA were lower in immigrants (aOR: 0.67, 95% CI: 0.47, 0.95), relative to the general population. Northern urban residence (aOR: 1.45, 95% CI: 1.13, 1.87) was associated with a higher odds of POHCA, relative to southern urban residence. Conclusions Children living in neighborhoods with high levels of marginalization may have an elevated risk of experiencing POHCA. These findings highlight the importance of addressing disparities through targeted prevention and intervention efforts.

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Section: Discussionmentioning

confidence: 75%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Sociodemographic Factors and the Risk of Pediatric Out‐of‐Hospital Cardiac Arrest in Ontario, Canada: A Province‐Wide Case–Control Study

Idrees,

Anderson,

Choi

et al. 2024

JAHA

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“…In a 10-year single-centre study from Finland, 65% of POHCA patients had ‘suspected or diagnosed chronic or otherwise significant conditions’ [ 35 ]. Among Canadian atraumatic POHCA patients, 16.2% of those who died before hospital discharge had had a ‘significant comorbidity’ [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Mortality after paediatric emergency calls for patients with or without pre-existing comorbidity: a nationwide population based cohort study

Nielsen,

Søvsø,

Skals

et al. 2024

Scand J Trauma Resusc Emerg Med

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Background Life-threatening conditions are infrequent in children. Current literature in paediatric prehospital research is centred around trauma and paediatric out-of-hospital cardiac arrests (POHCA). The aims of this study were to (1) outline the distribution of trauma, POHCA or other medical symptoms among survivors and non-survivors after paediatric emergency calls, and (2) to investigate these clinical presentations’ association with mortality in children with and without pre-existing comorbidity, respectively. Methods Nationwide population-based cohort study including ground and helicopter emergency medical services in Denmark for six consecutive years (2016–2021). The study included all calls to the emergency number 1-1-2 regarding children ≤ 15 years (N = 121,230). Interhospital transfers were excluded, and 1,143 patients were lost to follow-up. Cox regressions were performed with trauma or medical symptoms as exposure and 7-day mortality as the outcome, stratified by ‘Comorbidity’, ‘Severe chronic comorbidity’ and ’None’ based on previous healthcare visits. Results Mortality analysis included 76,956 unique patients (median age 5 (1–12) years). Annual all-cause mortality rate was 7 per 100,000 children ≤ 15 years. For non-survivors without any pre-existing comorbidity (n = 121), reasons for emergency calls were trauma 18.2%, POHCA 46.3% or other medical symptoms 28.9%, whereas the distribution among the 134 non-survivors with any comorbidity was 7.5%, 27.6% and 55.2%, respectively. Compared to trauma patients, age- and sex-adjusted hazard ratio for patients with calls regarding medical symptoms besides POHCA was 0.8 [0.4;1.3] for patients without comorbidity, 1.1 [0.5;2.2] for patients with comorbidity and 6.1 [0.8;44.7] for patients with severe chronic comorbidity. Conclusion In both non-survivors with and without comorbidity, a considerable proportion of emergency calls had been made because of various medical symptoms, not because of trauma or POHCA. This outline of diagnoses and mortality following paediatric emergency calls can be used for directing paediatric in-service training in emergency medical services.

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“…Survival rates at discharge for adult OHCA cases have been reported to range from 13% to 15% in recent years, although there is variation across reports [ 35 , 36 , 37 ]. Conversely, survival rates at discharge for pediatric OHCA cases are generally lower, ranging from 5–9%, with some reports showing survival rates > 10% [ 38 , 39 , 40 , 41 , 42 ].…”

Section: Introductionmentioning

confidence: 99%

Differences in Pathophysiology and Treatment Efficacy Based on Heterogeneous Out-of-Hospital Cardiac Arrest

Utsumi,

Nishikimi,

Ohshimo

et al. 2024

Medicina

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Out-of-hospital cardiac arrest (OHCA) is heterogeneous in terms of etiology and severity. Owing to this heterogeneity, differences in outcome and treatment efficacy have been reported from case to case; however, few reviews have focused on the heterogeneity of OHCA. We conducted a literature review to identify differences in the prognosis and treatment efficacy in terms of CA-related waveforms (shockable or non-shockable), age (adult or pediatric), and post-CA syndrome severity and to determine the preferred treatment for patients with OHCA to improve outcomes.

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Epidemiology of paediatric out-of-hospital cardiac arrest in Ontario, Canada

Cited by 7 publications

References 16 publications

Sociodemographic Factors and the Risk of Pediatric Out‐of‐Hospital Cardiac Arrest in Ontario, Canada: A Province‐Wide Case–Control Study

Sociodemographic Factors and the Risk of Pediatric Out‐of‐Hospital Cardiac Arrest in Ontario, Canada: A Province‐Wide Case–Control Study

Mortality after paediatric emergency calls for patients with or without pre-existing comorbidity: a nationwide population based cohort study

Differences in Pathophysiology and Treatment Efficacy Based on Heterogeneous Out-of-Hospital Cardiac Arrest

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