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

TY - JOUR

T1 - Epidemiology and outcome of paediatric out-of-hospital cardiac arrests

T2 - A paediatric sub-study of the Pan-Asian resuscitation outcomes study (PAROS)

AU - Tham, Lai Peng

AU - Wah, Win

AU - Phillips, Rachel

AU - Shahidah, Nur

AU - Ng, Yih Yng

AU - Shin, Sang Do

AU - Nishiuchi, Tatsuya

AU - Wong, Kwanhathai Darin

AU - Ko, Patrick Chow In

AU - Khunklai, Nalinas

AU - Naroo, Ghulam Yasin

AU - Ong, Marcus Eng Hock

PY - 2018/4/1

Y1 - 2018/4/1

N2 - 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.

AB - 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.

KW - Emergency medical service

KW - Epidemiology

KW - Out-of-hospital cardiac arrest

KW - Outcome

KW - paediatric

KW - Paediatric

KW - Pan asian resuscitation outcome study

KW - Pre-hospital

KW - Resuscitation

UR - http://www.scopus.com/inward/record.url?scp=85042201212&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2018.01.040

DO - 10.1016/j.resuscitation.2018.01.040

M3 - Article

AN - SCOPUS:85042201212

SN - 0300-9572

VL - 125

SP - 111

EP - 117

JO - Resuscitation

JF - Resuscitation

ER -