Epidemiology and outcome of paediatric out-of-hospital cardiac arrests: A paediatric sub-study of the Pan-Asian resuscitation outcomes study (PAROS)
Journal
Resuscitation
Journal Volume
125
Pages
111-117
Date Issued
2018
Author(s)
Tham L.P.
Wah W.
Phillips R.
Shahidah N.
Ng Y.Y.
Shin S.D.
Nishiuchi T.
Wong K.D.
Khunklai N.
Naroo G.Y.
Ong M.E.H.
Abstract
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. ? 2018 Elsevier B.V.
SDGs
Other Subjects
amiodarone; atropine; epinephrine; adolescent; Article; child; clinical outcome; female; hospital discharge; human; Korea; major clinical study; male; out of hospital cardiac arrest; outcome assessment; priority journal; respiration control; resuscitation; retrospective study; Singapore; survival; survival rate; Asia; clinical trial; emergency health service; epidemiology; health survey; infant; mortality; multicenter study; newborn; out of hospital cardiac arrest; outcome assessment; preschool child; prospective study; statistics and numerical data; Adolescent; Asia; Cardiopulmonary Resuscitation; Child; Child, Preschool; Emergency Medical Services; Female; Humans; Infant; Infant, Newborn; Male; Out-of-Hospital Cardiac Arrest; Outcome Assessment (Health Care); Population Surveillance; Prospective Studies
Type
journal article