Pediatric out-of-hospital cardiac arrest in Denmark

Abstract

Background Pediatric out-of-hospital cardiac arrest (POHCA) has received limited attention. All causes of POHCA and outcomes were examined during a 4-year period in a Danish nationwide register and prehospital medical records. The aim was to describe the incidence, reversible causes, and survival rates for POHCA in Denmark. Methods This is a registry-based follow-up cohort study. All POHCA for a 4-year period (2016–2019) in Denmark were included. All prehospital medical records for the included subjects were reviewed manually by five independent raters establishing whether a presumed reversible cause could be assigned. Results We identified 173 cases within the study period. The median incidence of POHCA in the population below 17 years of age was 4.2 per 100,000 persons at risk. We found a presumed reversible cause in 48.6% of cases, with hypoxia being the predominant cause of POHCA (42.2%). The thirty-day survival was 40%. Variations were seen across age groups, with the lowest survival rate in cases below 1 year of age. Defibrillators were used more frequently among survivors, with 16% of survivors defibrillated bystanders as opposed to 1.9% in non-survivors and 24% by EMS personnel as opposed to 7.8% in non-survivors. The differences in initial rhythm being shockable was 34% for survivors and 16% for non-survivors. Conclusion We found pediatric out-of-hospital cardiac arrests was a rare event, with higher incidence and mortality in infants compared to other age groups of children. Use of defibrillators was disproportionally higher among survivors. Hypoxia was the most common presumed cause among all age groups.

Characteristics and critical care interventions in drowning patients treated by the Danish Air Ambulance from 2016 to 2021: a nationwide registry-based study with 30-day follow-up

“…For the paediatric subpopulation below 6 years, the 30-day survival was 75% compared to only 22.7% in the elderly individuals above 65 years. The improved survival rates in children are consistent with other studies of paediatric emergencies [ 7 , 27 , 28 ], and drowning-related OHCA in children may be correlated with a higher rate of bystander first aid and CPR [ 29 , 30 ]. Also, one study indicated that paediatric drowning events were more likely to occur in swimming pools [ 7 ], which is associated with improved survival [ 12 ].…”

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

“…En esta serie, el que la parada fuese presenciada se asoció con la supervivencia mientras que no tuvo significación estadística la realización de soporte vital previo (SVP). Es posible que se deba a que la reanimación por testigos, la más precoz, se dio solo en el 30% de los casos, un porcentaje bajo cuando se compara con otros registros en los que el porcentaje de reanimación previa llega hasta el 85% de las paradas presenciadas 18 . El grueso del SVP correspondió a servicios sanitarios que, o se desplazaron al lugar de la parada, o en ocasiones, les trasladan al paciente al punto de urgencias extrahospitalarias.…”

“…La incidencia documentada es muy variable, con una amplia horquilla entre 0,5 y 20 casos por 100.000 habitantes y año. Esta variabilidad es debida a múltiples factores, y uno de los más importantes es los criterios de inclusión por los que se rige cada estudio 2,[4][5][6] , tanto en las definiciones de la edad pediátrica como a la hora de incluir o no todas las etiologías. De hecho, aunque el estilo Utsein para la definición y recogida de variables 7 está firmemente extendido, la clasificación y categorización de la edad pediátrica varía de manera notable en los diferentes registros [8][9][10] .…”

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

“…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 ].…”