Characteristics and Outcomes of Pediatric Out-of-Hospital Cardiac Arrest by Scholastic Age Category*

Abstract

There is a paucity of data examining nationwide population-based incidences and outcomes of pediatric out-of-hospital cardiac arrest. The objective of this study is to describe the detailed characteristics of pediatric out-of-hospital cardiac arrest by scholastic age category and to evaluate the impact of bystander cardiopulmonary resuscitation and public access-automated external defibrillators on the 1-month survival and favorable neurological status of pediatric out-of-hospital cardiac arrest patients. A nationwide, population-based, observational study. Nationwide emergency medical system in Japan. Out-of-hospital cardiac arrest patients aged ≤ 18 yr. We identified 7,624 pediatric out-of-hospital cardiac arrest patients (≤ 18 yr old) from a nationwide population-based out-of-hospital cardiac arrest database in Japan from 2005 to 2008 and stratified them into five categories by scholastic age. The overall rates of 1-month survival and favorable neurological outcomes were 11.0% and 5.1%, respectively. Bystander cardiopulmonary resuscitation resulted in a significant improvement in both 1-month survival (odds ratio 2.81; 95% confidence interval 2.30-3.44) and favorable neurological outcomes (odds ratio 4.55; 95% confidence interval 3.35-6.18). Performing public access-automated external defibrillators had a significant effect on the 1-month survival rate (odds ratio 3.51; 95% confidence interval 1.81-6.81) and favorable neurological outcomes (odds ratio 5.13; 95% confidence interval 2.64-9.96). This study demonstrated that bystander cardiopulmonary resuscitation and public access-automated external defibrillators had a significant impact on the outcomes of pediatric out-of-hospital cardiac arrest. The improved survival associated with bystander cardiopulmonary resuscitation and public access-automated external defibrillators are clinically important and are of major public health importance for school-aged out-of-hospital cardiac arrest patients.