Abstract 255: Analysis of Out-of-Hospital Cardiac Arrest in Infants, Children and Adolescents in the Kyushu Area in Japan by Locally Obtained Data

Abstract

Background: The Fire and Disaster Management Agency of Japan launched a population-based cohort study of patients suffering from OHCA in 2005. However, more detailed data on each OHCA case may be required to determine any confounders present in each area to prevent locally occurring OHCA. Methods and Results: The Council for School-Based Screening Programs of the Kyushu Medical Associations started to obtain data of each case of out-of-hospital cardiac arrest (OHCA) <20 years of age from school boards, school physicians, and local fire departments in the Kyushu area in 2012 using a questionnaire. The questionnaire asked information used in the Utstein form and more detailed situations about OHCA cases. In logistic regression analysis, age, sex, the location of OHCA (at home or not at home), the timing of OHCA (during sleep or not during sleep), the presence of resuscitation, and the use of an AED were used as dependent variables. Sixty-seven cases of OHCA were obtained in 2002 and 2003. The prevalence of OHCA in each Prefecture corresponded to 0.29 to 4.17 per 100,000 subjects (Okamoto et al. Circ J, 2013), indicating that less than half of the annual cases in Kyushu area were obtained. Of 67 cases of OHCA, 20, 7, 13, and 27 cases occurred in those aged 0, 1-5, 6-12, and 13-18 years, respectively. Of 40 cases of OHCA that occurred at home, 37 (93%) were fatal. Among 20 infant cases, 16 (80%) occurred during sleeping. Of 27 young adolescent cases, 5 were found dead in the bath. In logistic regression analysis, OHCA occurring at home was a sole predictive factor for death (p=0.000, 95% confidence interval: 4.4-73.1). Conclusions: To improve the prevalence and outcome of OHCA cases in the pediatric population, information on resuscitation should be provided to parents. New strategies for sudden infant death during sleeping should be examined, such as electrocardiographic screening at 1 month old (Schwartz PJ, et al. Circulation, 2009: Yoshinaga M, et al. Circ Arrhythm Electrophysiol, 2013). Bathing is at high risk of OHCA, not only in the elderly population, but also in the young population.