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Pediatric Critical Care Medicine:
doi: 10.1097/PCC.0b013e31829763e2
Feature Articles

Long-Term Outcomes Following Pediatric Out-of-Hospital Cardiac Arrest*

Michiels, Erica A. MD1,2,3; Dumas, Florence MD, PhD4; Quan, Linda MD1,3; Selby, Leah MD1; Copass, Michael MD1; Rea, Thomas MD, MPH1

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Abstract

Objectives: Pediatric out-of-hospital cardiac arrest is an uncommon event with measurable short-term survival to hospital discharge. For those who survive to hospital discharge, little is known regarding duration of survival. We sought to evaluate the arrest circumstances and long-term survival of pediatric patients who experienced an out-of-hospital cardiac arrest and survived to hospital discharge.

Design: Retrospective cohort study

Setting: King County, WA Emergency Medical Service Catchment and Quaternary Care Children’s Hospital

Patients: Persons less than 19 years old who had an out-of-hospital cardiac arrest and were discharged alive from the hospital between 1976 and 2007.

Intervention: None.

Measurements and Main Results: During the study period, 1,683 persons less than 19 years old were treated for pediatric out-of-hospital cardiac arrest in the study community, with 91 patients surviving to hospital discharge. Of these 91 survivors, 20 (22%) subsequently died during 1449 person-years of follow-up. Survival following hospital discharge was 92% at 1 year, 86% at 5 years, and 77% at 20 years. Compared to those who subsequently died, long-term survivors were more likely at the time of discharge to be older (mean age, 8 vs 1 yr), had a witnessed arrest (83% vs 56%), presented with a shockable rhythm (40% vs 10%), and had a favorable Pediatric Cerebral Performance Category of 1 or 2 (67% vs 0%).

Conclusions: In this population-based cohort study evaluating the long-term outcome of pediatric survivors of out-of-hospital cardiac arrest, we observed that long-term survival was generally favorable. Age, arrest characteristics, and functional status at hospital discharge were associated with prognosis. These findings support efforts to improve pediatric resuscitation, stabilization, and convalescent care.

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

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