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. 2023 Jun:187:109768.
doi: 10.1016/j.resuscitation.2023.109768. Epub 2023 Mar 17.

Long-term function, quality of life and healthcare utilization among survivors of pediatric out-of-hospital cardiac arrest

Meredith R Hickson  1 , Madeline Winters  1 , Nina H Thomas  2 , Monique M Gardner  1 , Matthew P Kirschen  1 , Vinay Nadkarni  1 , Robert Berg  1 , Beth S Slomine  3 , Neethi P Pinto  1 , Alexis Topjian  4
Affiliations

Long-term function, quality of life and healthcare utilization among survivors of pediatric out-of-hospital cardiac arrest

Meredith R Hickson et al. Resuscitation. 2023 Jun.

Abstract

Background: Survival following pediatric out-of-hospital cardiac arrest (OHCA) has improved over the past 2 decades but data on survivors' long-term outcomes are limited. We aimed to evaluate long-term outcomes in pediatric OHCA survivors more than one year after cardiac arrest.

Methods: OHCA survivors <18 years old who received post-cardiac arrest care in the PICU at a single center between 2008-2018 were included. Parents of patients <18 years and patients ≥18 years at least one year after cardiac arrest completed a telephone interview. We assessed neurologic outcome (Pediatric Cerebral Performance Category [PCPC]), activities of daily living (Pediatric Glasgow Outcomes Scale-Extended, Functional Status Scale (FSS)), HRQL (Pediatric Quality of Life Core and Family Impact Modules), and healthcare utilization. Unfavorable neurologic outcome was defined as PCPC > 1 or worsening from pre-arrest baseline to discharge.

Findings: Forty four patients were evaluable. Follow-up occurred at a median of 5.6 years [IQR 4.4, 8.9] post-arrest. Median age at arrest was 5.3 [1.3,12.6] years; median CPR duration was 5 [1.5, 7] minutes. Survivors with unfavorable outcome at discharge had worse FSS Sensory and Motor Function scores and higher rates of rehabilitation service utilization. Parents of survivors with unfavorable outcome reported greater disruption to family functioning. Healthcare utilization and educational support requirements were common among all survivors.

Conclusions: Survivors of pediatric OHCA with unfavorable outcome at discharge have more impaired function multiple years post-arrest. Survivors with favorable outcome may experience impairments and significant healthcare needs not fully captured by the PCPC at hospital discharge.

Keywords: Health-related quality of life; Healthcare utilization; Out-of-hospital cardiac arrest; Outcomes; Pediatric cardiac arrest.

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Conflict of interest statement

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1 –
Fig. 1 –
Participant screening, enrollment, and attrition.
Fig. 2 –
Fig. 2 –. Distribution of PCPC at long-term follow-up based on Discharge PCPC.
Abbreviations: PCPC, Pediatric Cerebral Performance Category
See this image and copyright information in PMC

Comment in

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