National Surveillance of Pediatric Out-of-Hospital Cardiac Arrest in Korea: The 10-Year Trend From 2009 to 2018

Abstract

Background This study reports trends in pediatric out-of-hospital cardiac arrest (OHCA) and factors affecting clinical outcomes by age group. Methods We identified 4,561 OHCA patients younger than 18 years between January 2009 and December 2018 in the Korean OHCA Registry. The patients were divided into four groups: group 1 (1 year or younger), group 2 (1 to 5 years), group 3 (6 to 12 years), and group 4 (13 to 17 years). The primary outcome was survival to hospital discharge, and the secondary outcomes were return of spontaneous circulation (ROSC) at the emergency department (ED) and good neurological status at discharge. Multivariate logistic analyses were performed. Results The incidence rate of pediatric OHCA in group 1 increased from 45.57 to 60.89 per 100,000 person-years, while that of the overall population decreased over the 10 years. The rates of ROSC at the ED, survival to hospital discharge, and good neurologic outcome were highest in group 4 (37.9%, 9.7%, 4.9%, respectively) and lowest in group 1 (28.3%, 7.1%, 3.2%). The positive factors for survival to discharge were event location of a public/commercial building or place of recreation, type of first responder, prehospital delivery of automated external defibrillator shock, initial shockable rhythm at the ED. The factors affecting survival outcomes differed by age group. Conclusion This study reports comprehensive trends in pediatric OHCA in the Republic of Korea. Our findings imply that preventive methods for the targeted population should be customized by age group.

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

“…Furthermore, 80–90% of survivors experience excellent outcomes in developed countries and regions with well-established cardiopulmonary resuscitation systems, according to the 2020 World Resuscitation Congress [ 30 ]. For pediatric CA, the number of patients with favorable neurological outcomes at discharge (e.g., pediatric cerebral performance category 1–2) is lower than that of adults, ranging no higher than 10% [ 32 , 33 , 34 , 43 , 44 ]. Thus, pediatric patients who experience OHCA have higher mortality rates and poorer neurologic prognoses than adult patients.…”

Effect of Intermediate Airway Management on Ventilation Parameters in Simulated Pediatric Out-of-Hospital Cardiac Arrest: Protocol for a Multicenter, Randomized, Crossover Trial

“…Survival rates after pediatric out-of-hospital cardiac arrest (OHCA) are still excessively low despite many advances in resuscitation science over the past decades, with recent studies reporting rates of survival to hospital discharge ranging from 0.0% to 21.2% [1][2][3]. Generally, pediatric OHCA is secondary to hypoxia [4], with sudden infant death syndrome, trauma and drowning being the most common etiologies [5].…”