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 - Funding Information:
Dr. Fink reports funding from the Patient Centered Outcomes Research Institute and National Institutes of Health , neither of which had involvement in this research paper.
Funding Information:
The study was supported through research grants from: the ROC is supported by a series of cooperative agreements to nine regional clinical centers and one Data Coordinating Center ( 5U01 HL077863 — University of Washington Data Coordinating Center , HL077866 — Medical College of Wisconsin , HL077867 — University of Washington , HL077871 — University of Pittsburgh , HL077872 — St. Michael’s Hospital , HL077873 — Oregon Health and Science University , HL077881 — University of Alabama at Birmingham , HL077885 — Ottawa Hospital Research Institute , HL077887 — University of Texas SW Medical Ctr/Dallas , HL077908 — University of California San Diego ) from the National Heart, Lung and Blood Institute in partnership with the National Institute of Neurological Disorders and Stroke, U.S. Army Medical Research & Material Command, The Canadian Institutes of Health Research (CIHR)—Institute of Circulatory and Respiratory Health, Defence Research and Development Canada and the Heart, Stroke Foundation of Canada and the American Heart Association. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung and Blood Institute or the National Institutes of Health.
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
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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 -