Epidemiology and outcome of paediatric out-of-hospital cardiac arrests: A paediatric sub-study of the Pan-Asian resuscitation outcomes study (PAROS)

RESUSCITATION

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Article

Tham, Lai Peng¹  Wah, Win²  Phillips, Rachel³  Shahidah, Nur²  Ng, Yih Yng⁴  Shin, Sang Do⁵  Nishiuchi, Tatsuya⁶  Wong, Kwanhathai Darin⁷  Ko, Patrick Chow-In⁸  Khunklai, Nalinas⁹  Naroo, Ghulam Yasin¹⁰  Ong, Marcus Eng Hock^2,11 

[1] KK Womens & Childrens Hosp, Dept Emergency Med, Singapore, Singapore

[2] Singapore Gen Hosp, Dept Emergency Med, Singapore, Singapore

[3] Kings Coll London, Dept Primary Care & Publ Hlth Sci, London, England

[4] Singapore Civil Def Force, Med Dept, Singapore, Singapore

[5] Seoul Natl Univ, Coll Med, Dept Emergency Med, Seoul, South Korea

[6] Kindai Univ, Fac Med, Dept Acute Med, Osaka, Japan

[7] Hosp Pulau Pinang, Emergency Dept, George Town, Malaysia

[8] Natl Taiwan Univ, Natl Taiwan Univ Hosp, Dept Emergency Med, Taipei, Taiwan

[9] Rajavithi Hosp, Dept Emergency Med, Bangkok, Thailand

[10] Rashid Hosp, Dept Hlth & Med Serv, ED Trauma Ctr, Dubai, U Arab Emirates

[11] Duke NUS Grad Med Sch, Hlth Serv & Syst Res, Singapore, Singapore

关键词: Paediatric paediatric;    Out-of-hospital cardiac arrest;    Resuscitation;    Pre-hospital;    Emergency medical service;    Epidemiology;    Outcome;    Pan asian resuscitation outcome study;   

DOI  :  10.1016/j.resuscitation.2018.01.040

来源: Elsevier

【 摘 要 】

Background: The Pan Asian Resuscitation Outcomes Study (PAROS) is a retrospective study of out-of-hospital cardiac arrest(OHCA), collaborating with EMS agencies and academic centers in Japan, South Korea, Malaysia, Singapore, Taiwan, Thailand and UAE-Dubai. The objectives of this study is to describe the characteristics and outcomes, and to find factors associated with survival after paediatric OHCA. Methods: We studied all children less than 17 years of age with OHCA conveyed by EMS and non-EMS transports from January 2009 to December 2012. We did univariate and multivariate logistic regression analyses to assess the factors associated with survival-to-discharge outcomes. Results: A total of 974 children with OHCA were included. Bystander cardiopulmonary resuscitation rates ranged from 53.5% (Korea), 35.6% (Singapore) to 11.8% (UAE). Overall, 8.6% (range 0%-9.7%) of the children survived to discharge from hospital. Adolescents (13-17 years) had the highest survival rate of 13.8%. 3.7% of the children survived with good neurological outcomes of CPC 1 or 2. The independent pre-hospital factors associated with survival to discharge were witnessed arrest and initial shockable rhythm. In the sub-group analysis, pre-hospital advanced airway [odds ratio (OR) = 3.35, 95% confidence interval (CI) = 1.23-9.13] was positively associated with survival-to-discharge outcomes in children less than 13 years-old. Among adolescents, bystander CPR (OR = 2.74, 95% CI = 1.03-7.3) and initial shockable rhythm (OR = 20.51, 95% CI = 2.15-195.7) were positive factors. Conclusion: The wide variation in the survival outcomes amongst the seven countries in our study may be due to the differences in the delivery of pre-hospital interventions and bystander CPR rates.

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