TY - JOUR
T1 - Unchanged pediatric out-of-hospital cardiac arrest incidence and survival rates with regional variation in North America
AU - Fink, Ericka L.
AU - Prince, David K.
AU - Kaltman, Jonathan R.
AU - Atkins, Dianne L.
AU - Austin, Michael
AU - Warden, Craig
AU - Hutchison, Jamie
AU - Daya, Mohamud
AU - Goldberg, Scott
AU - Herren, Heather
AU - Tijssen, Janice A.
AU - Christenson, James
AU - Vaillancourt, Christian
AU - Miller, Ronna
AU - Schmicker, Robert H.
AU - Callaway, Clifton W.
N1 - Publisher Copyright:
© 2016 Elsevier Ireland Ltd
PY - 2016/10/1
Y1 - 2016/10/1
N2 - 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 (3 days–1 year), 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 5 year period. Regional variation represents an opportunity for further study to improve outcomes.
AB - 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 (3 days–1 year), 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 5 year period. Regional variation represents an opportunity for further study to improve outcomes.
KW - Cardiac arrest
KW - Epidemiology
KW - Outcomes
KW - Pediatric
KW - Resuscitation
UR - http://www.scopus.com/inward/record.url?scp=84985041031&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84985041031&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2016.07.244
DO - 10.1016/j.resuscitation.2016.07.244
M3 - Article
C2 - 27565862
AN - SCOPUS:84985041031
SN - 0300-9572
VL - 107
SP - 121
EP - 128
JO - Resuscitation
JF - Resuscitation
ER -