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
. 2022 Nov 17;30(1):58.
doi: 10.1186/s13049-022-01045-x.

Pediatric out-of-hospital cardiac arrest in Denmark

Mathias Geldermann Holgersen  1   2   3 , Theo W Jensen  2   4 , Niklas Breindahl  2   4   5 , Julie L B Kjerulff  6 , Sara H Breindahl  1   2 , Stig Nikolaj Fasmer Blomberg  7 , Signe Amalie Wolthers  2   4 , Lars Bredevang Andersen  4 , Christian Torp-Pedersen  8   9 , Søren Mikkelsen  10 , Freddy Lippert  2   11 , Helle Collatz Christensen  2   4   12 ; Danish Cardiac Arrest Registry Group
Affiliations

Pediatric out-of-hospital cardiac arrest in Denmark

Mathias Geldermann Holgersen et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: Pediatric out-of-hospital cardiac arrest (POHCA) has received limited attention. All causes of POHCA and outcomes were examined during a 4-year period in a Danish nationwide register and prehospital medical records. The aim was to describe the incidence, reversible causes, and survival rates for POHCA in Denmark.

Methods: This is a registry-based follow-up cohort study. All POHCA for a 4-year period (2016-2019) in Denmark were included. All prehospital medical records for the included subjects were reviewed manually by five independent raters establishing whether a presumed reversible cause could be assigned.

Results: We identified 173 cases within the study period. The median incidence of POHCA in the population below 17 years of age was 4.2 per 100,000 persons at risk. We found a presumed reversible cause in 48.6% of cases, with hypoxia being the predominant cause of POHCA (42.2%). The thirty-day survival was 40%. Variations were seen across age groups, with the lowest survival rate in cases below 1 year of age. Defibrillators were used more frequently among survivors, with 16% of survivors defibrillated bystanders as opposed to 1.9% in non-survivors and 24% by EMS personnel as opposed to 7.8% in non-survivors. The differences in initial rhythm being shockable was 34% for survivors and 16% for non-survivors.

Conclusion: We found pediatric out-of-hospital cardiac arrests was a rare event, with higher incidence and mortality in infants compared to other age groups of children. Use of defibrillators was disproportionally higher among survivors. Hypoxia was the most common presumed cause among all age groups.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Modified CONSORT diagram. In- and exclusion of subjects including allocation of presumed reversible causes assigned by independent raters reading the prehospital medical charts. Lesions incompatible with life consists of obviously fatal injuries that are not compatible with continued life for which resuscitation efforts are not performed (e.g., the head separated from the body). In 16 cases caused by trauma resuscitation efforts were performed without raters able to identify a presumed reversible cause. Of these 69% (N = 11) were head injuries
Fig. 2
Fig. 2
Distribution of age in pediatric out-of-hospital cardiac arrest in Denmark from 2016 to 2019. Incidence according to age for males (blue) and females (red). Solid lines depict smoothed moving averages (dark blue = males, dark red = females)
See this image and copyright information in PMC

References

    1. Van de Voorde P, Turner NM, Djakow J, de Lucas N, Martinez-Mejias A, Biarent D, et al. European resuscitation council guidelines 2021: paediatric life support. Resuscitation. 2021;161:327–387. doi: 10.1016/j.resuscitation.2021.02.015. - DOI - PubMed
    1. Mikkelsen S, Schaffalitzky de Muckadell C, Binderup LG, Lossius HM, Toft P, Lassen AT. Termination of prehospital resuscitative efforts: a study of documentation on ethical considerations at the scene. Scand J Trauma Resusc Emerg Me. 2017;25(1):1–9. - PMC - PubMed
    1. Rajan S, Wissenberg M, Folke F, Hansen CM, Lippert FK, Weeke P, et al. Out-of-hospital cardiac arrests in children and adolescents: incidences, outcomes, and household socioeconomic status. Resuscitation. 2015;88:12–19. doi: 10.1016/j.resuscitation.2014.11.025. - DOI - PubMed
    1. Ong ME, Stiell I, Osmond MH, Nesbitt L, Gerein R, Campbell S, et al. Etiology of pediatric out-of-hospital cardiac arrest by coroner's diagnosis. Resuscitation. 2006;68(3):335–342. doi: 10.1016/j.resuscitation.2005.05.026. - DOI - PubMed
    1. Sirbaugh PE, Pepe PE, Shook JE, Kimball KT, Goldman MJ, Ward MA, et al. A prospective, population-based study of the demographics, epidemiology, management, and outcome of out-of-hospital pediatric cardiopulmonary arrest. Ann Emerg Med. 1999;33(2):174–184. doi: 10.1016/S0196-0644(99)70391-4. - DOI - PubMed