Incidence, Causes, and Outcomes of Out-of-Hospital Cardiac Arrest in Children A Comprehensive, Prospective, Population-Based Study in the Netherlands

Abdennasser Bardai, Jocelyn Berdowski, Christian van der Werf, Marieke T. Blom, Manon Ceelen, Irene M. van Langen, Jan G. P. Tijssen, Arthur A. M. Wilde, Rudolph W. Koster, Hanno L. Tan

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Abstract

Objectives This study sought to determine comprehensively the incidence of pediatric out-of-hospital cardiac arrest (OHCA) and its contribution to total pediatric mortality, the causes of pediatric OHCA, and the outcome of resuscitation of pediatric OHCA patients. Background There is a paucity of complete studies on incidence, causes, and outcomes of pediatric OHCA. Methods In this prospective, population-based study, OHCA victims younger than age 21 years in 1 province of the Netherlands were registered through both emergency medical services and coroners over a period of 4.3 years. Death certificate data on total pediatric mortality, survival status, and neurological outcome at hospital discharge also were obtained. Results With a total mortality of 923 during the study period and 233 victims of OHCA (including 221 who died and 12 who survived), OHCA caused 24% (221 of 923) of total pediatric mortality. Natural causes of OHCA amounted to 115 (49%) cases, with cardiac causes being most prevalent (n = 90, 39%). The incidence of pediatric OHCA was 9.0 per 100,000 pediatric person-years (95% confidence interval: 7.8 to 10.3), whereas the incidence of pediatric OHCA from cardiac causes was 3.2 (95% confidence interval: 2.5 to 3.9). Of 51 resuscitated patients, 12 (24%) survived; among survivors, 10 (83%) had a neurologically intact outcome. Conclusions Out-of-hospital cardiac arrest accounts for a significant proportion of pediatric mortality, and cardiac causes are the most prevalent causes of OHCA. The vast majority of OHCA survivors have a neurologically intact outcome. (J Am Coll Cardiol 2011; 57: 1822-8) (C) 2011 by the American College of Cardiology Foundation
Original languageEnglish
Pages (from-to)1822-1828
JournalJournal of the American College of Cardiology
Volume57
Issue number18
DOIs
Publication statusPublished - 2011

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