Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Oct:107:121-8.
doi: 10.1016/j.resuscitation.2016.07.244. Epub 2016 Aug 24.

Unchanged pediatric out-of-hospital cardiac arrest incidence and survival rates with regional variation in North America

Ericka L Fink  1 , David K Prince  2 , Jonathan R Kaltman  3 , Dianne L Atkins  4 , Michael Austin  5 , Craig Warden  6 , Jamie Hutchison  7 , Mohamud Daya  8 , Scott Goldberg  9 , Heather Herren  2 , Janice A Tijssen  10 , James Christenson  11 , Christian Vaillancourt  12 , Ronna Miller  9 , Robert H Schmicker  2 , Clifton W Callaway  13 ; Resuscitation Outcomes Consortium
Affiliations

Unchanged pediatric out-of-hospital cardiac arrest incidence and survival rates with regional variation in North America

Ericka L Fink et al. Resuscitation. 2016 Oct.

Abstract

Aim: Outcomes for pediatric out-of-hospital cardiac arrest (OHCA) are poor. Our objective was to determine temporal trends in incidence and mortality for pediatric OHCA.

Methods: Adjusted incidence and hospital mortality rates of pediatric non-traumatic OHCA patients from 2007-2012 were analyzed using the 9 region Resuscitation Outcomes Consortium-Epidemiological Registry (ROC-Epistry) database. Children were divided into 4 age groups: perinatal (<3 days), infants (3days-1year), children (1-11 years), and adolescents (12-19 years). ROC regions were analyzed post-hoc.

Results: We studied 1738 children with OHCA. The age- and sex-adjusted incidence rate of OHCA was 8.3 per 100,000 person-years (75.3 for infants vs. 3.7 for children and 6.3 for adolescents, per 100,000 person-years, p<0.001). Incidence rates differed by year (p<0.001) without overall linear trend. Annual survival rates ranged from 6.7-10.2%. Survival was highest in the perinatal (25%) and adolescent (17.3%) groups. Stratified by age group, survival rates over time were unchanged (all p>0.05) but there was a non-significant linear trend (1.3% increase) in infants. In the multivariable logistic regression analysis, infants, unwitnessed event, initial rhythm of asystole, and region were associated with worse survival, all p<0.001. Survival by region ranged from 2.6-14.7%. Regions with the highest survival had more cases of EMS-witnessed OHCA, bystander CPR, and increased EMS-defibrillation (all p<0.05).

Conclusions: Overall incidence and survival of children with OHCA in ROC regions did not significantly change over a recent 5year period. Regional variation represents an opportunity for further study to improve outcomes.

Keywords: Cardiac arrest; Epidemiology; Outcomes; Pediatric; Resuscitation.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CONSORT Diagram.
Figure 2
Figure 2
Incidence Rates by Year and Age Group with Estimated Linear Differences. Shaded areas represent 95% confidence intervals.
Figure 3
Figure 3
Survival to Hospital Discharge for Cardiac Arrest by Year and Age Group with Estimated Linear Differences. Vertical bars represent standard error.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Atkins DL, Everson-Stewart S, Sears GK, et al. Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. Circulation. 2009;119:1484–91. - PMC - PubMed
    1. Young KD, Gausche-Hill M, McClung CD, Lewis RJ. A prospective, population-based study of the epidemiology and outcome of out-of-hospital pediatric cardiopulmonary arrest. Pediatrics. 2004;114:157–64. - PubMed
    1. Topjian AA, French B, Sutton RM, et al. Early postresuscitation hypotension is associated with increased mortality following pediatric cardiac arrest. Crit Care Med. 2014;42:1518–23. - PMC - PubMed
    1. Del Castillo J, Lopez-Herce J, Matamoros M, et al. Hyperoxia, hypocapnia and hypercapnia as outcome factors after cardiac arrest in children. Resuscitation. 2012;83:1456–61. - PubMed
    1. Johnson MA, Grahan BJ, Haukoos JS, et al. Demographics, bystander CPR, and AED use in out-of-hospital pediatric arrests. Resuscitation. 2014;85:920–6. - PMC - PubMed

Publication types