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Pediatric Critical Care Medicine:
doi: 10.1097/PCC.0b013e31827129b3
Feature Articles

Characteristics and Outcomes of Pediatric Out-of-Hospital Cardiac Arrest by Scholastic Age Category*

Akahane, Manabu MD, PhD1; Tanabe, Seizan MD2; Ogawa, Toshio PhD1; Koike, Soichi MD, PhD3; Horiguchi, Hiromasa PhD4; Yasunaga, Hideo MD, PhD4; Imamura, Tomoaki MD, PhD1

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Abstract

Objectives: There is a paucity of data examining nationwide population-based incidences and outcomes of pediatric out-of-hospital cardiac arrest. The objective of this study is to describe the detailed characteristics of pediatric out-of-hospital cardiac arrest by scholastic age category and to evaluate the impact of bystander cardiopulmonary resuscitation and public access–automated external defibrillators on the 1-month survival and favorable neurological status of pediatric out-of-hospital cardiac arrest patients.

Design: A nationwide, population-based, observational study.

Setting: Nationwide emergency medical system in Japan.

Patients: Out-of-hospital cardiac arrest patients aged ≤ 18 yr.

Measurements and Main Results: We identified 7,624 pediatric out-of-hospital cardiac arrest patients (≤ 18 yr old) from a nationwide population-based out-of-hospital cardiac arrest database in Japan from 2005 to 2008 and stratified them into five categories by scholastic age. The overall rates of 1-month survival and favorable neurological outcomes were 11.0% and 5.1%, respectively. Bystander cardiopulmonary resuscitation resulted in a significant improvement in both 1-month survival (odds ratio 2.81; 95% confidence interval 2.30–3.44) and favorable neurological outcomes (odds ratio 4.55; 95% confidence interval 3.35–6.18). Performing public access–automated external defibrillators had a significant effect on the 1-month survival rate (odds ratio 3.51; 95% confidence interval 1.81–6.81) and favorable neurological outcomes (odds ratio 5.13; 95% confidence interval 2.64–9.96).

Conclusions: This study demonstrated that bystander cardiopulmonary resuscitation and public access–automated external defibrillators had a significant impact on the outcomes of pediatric out-of-hospital cardiac arrest. The improved survival associated with bystander cardiopulmonary resuscitation and public access–automated external defibrillators are clinically important and are of major public health importance for school-aged out-of-hospital card-iac arrest patients.

©2013The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

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