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

Abstract

Long-term outcomes after non-traumatic pediatric out-of-hospital cardiac arrest (OHCA) are not well understood. This systematic review aimed to summarize long-term outcomes (1 year and beyond), including overall survival, survival with favorable neurological outcomes, and health-related quality of life (HRQoL) outcomes) amongst pediatric OHCA patients who survived to discharge. Embase, Medline, and The Cochrane Library were searched from inception to October 6, 2021. Studies were included if they reported outcomes at 1 year or beyond after pediatric OHCA. Data abstraction and quality assessment was conducted by three authors independently. Qualitative outcomes were reported systematically. Seven studies were included, and amongst patients that survived to hospital discharge or to 30 days, longer-term survival was at least 95% at 24 months of follow up. A highly variable proportion (range 10–71%) of patients had favorable neurological outcomes at 24 months of follow up. With regard to health-related quality of life outcomes, at a time point distal to 1 year, at least 60% of pediatric non-traumatic OHCA patients were reported to have good outcomes. Our study found that at least 95% of pediatric OHCA patients, who survived to discharge, survived to a time point distal to 1 year. There is a general paucity of data surrounding the pediatric OHCA population.

Long-term survival after out-of-hospital cardiac arrest in children: outcomes in Andalusia in 2008-2019

“…En una reciente revisión, Celeste Ng et al 14 comunicaron resultados de supervivencia del 95% 26 y el 98% 17 en el seguimiento de los pacientes a más de un año del evento, si bien, la media de seguimiento en ambos casos fue de 2 años, sensiblemente inferior al de la presente serie, en la que dos de los tres fallecimientos sucedieron a los 6 y 11 años desde la parada. Por otra parte, la evolución a largo plazo del resto de pacientes fue buena.…”

“…Por otra parte, la baja incidencia de la PCREp dificulta encontrar series numerosas y que reporten periodos de seguimiento prolongados. La realidad es que no hay demasiada información sobre la PCREp que incluya series numerosas, con seguimiento a largo plazo de los pacientes y referencias al estado neurológico 14 . Nuestro objetivo fue conocer la supervivencia al alta y la evolución neurológica tras seguimiento a largo plazo de los pacientes pediátricos atendidos por una PCRE.…”

Long-term multidisciplinary follow-up programs in pediatric cardiac arrest survivors

“…8–39% survivors to hospital discharge after out-of-hospital cardiac arrest (OHCA)), and 2) CA in children occurs in broad age categories (0–17 years) with different stages of development of the central nervous system causing challenging neuroprognostication. 1 , 2 , 3 , 4 , 5 Also, long-term follow-up requires a CA registry and dedicated outcome teams.…”

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 ].…”