Pediatric out-of-hospital cardiac arrests : An epidemiological study

Journal article


Irvine, Rachel, Doan, Tan, Bosley, Emma, Colbeck, Marc and Bowles, Kelly-Ann. (2023). Pediatric out-of-hospital cardiac arrests : An epidemiological study. Prehospital Emergency Care. 27(6), pp. 718-727. https://doi.org/10.1080/10903127.2022.2096159
AuthorsIrvine, Rachel, Doan, Tan, Bosley, Emma, Colbeck, Marc and Bowles, Kelly-Ann
Abstract

Objective
To identify the epidemiological patterns of pediatric out-of-hospital cardiac arrests (OHCA) in Queensland, Australia and to investigate associations between patient variables and prehospital outcome.

Methods
Included were pediatric (>4 days–18 years) OHCA patients attended by paramedics in the state of Queensland (Australia) between January 2009 and December 2019. Patient and arrest characteristics were described. Factors associated with return of spontaneous circulation (ROSC) on hospital arrival were investigated.

Results
A total of 1,612 pediatric patients were included; 611 were deceased prior to paramedic arrival and 1,001 received resuscitation attempts by paramedics. Approximately one quarter (26.8%) of resuscitation-attempted patients achieved ROSC on hospital arrival. Most arrests (49.7%) were due to medical causes. Arrests due to trauma had the lowest rate of ROSC on hospital arrival (9.6%), whereas those due to drug overdose had the highest rate (40%). Patients in rural areas had a lower rate of ROSC on hospital arrival than those in metropolitan areas (20.7% vs 32.5%, p < 0.001). The median response interval to all OHCA patients was 8 minutes. Trauma was considerably more prevalent in rural areas than in metropolitan areas, while all other etiologies were comparable. Older pediatric age groups had higher rates of ROSC on hospital arrival than infants, particularly early adolescents (39.4% vs. 14.9%, p = 0.001). Etiology, age, bystander witness, shockable initial rhythm, and geographic locality factors were independently associated with ROSC on hospital arrival.

Conclusions
Approximately a quarter of pediatric prehospital OHCA achieved ROSC on hospital arrival. Prehospital outcome differs according to patient cohort and is associated with diverse patient demographic variables.

Year2023
JournalPrehospital Emergency Care
Journal citation27 (6), pp. 718-727
PublisherTaylor & Francis
ISSN1090-3127
Digital Object Identifier (DOI)https://doi.org/10.1080/10903127.2022.2096159
PubMed ID35771687
Scopus EID2-s2.0-85134545927
Page range718-727
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online22 Jul 2022
Publication process dates
Accepted27 Jun 2022
Deposited11 Aug 2023
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https://acuresearchbank.acu.edu.au/item/8z807/pediatric-out-of-hospital-cardiac-arrests-an-epidemiological-study

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