Abstract
Background: Postdischarge diseases (PDDs) have been reported for adult survivors of out-of-hospital cardiac arrest (OHCA). However, the detailed demographics of pediatric OHCA survivors with PDDs are not well-documented, and information regarding functional survivors is particularly limited. We aimed to report detailed information on the PDDs of survivors of traumatic and non-traumatic pediatric OHCA using a national healthcare database.Methods: We retrospectively obtained data from the Taiwan government healthcare database (2011–2015). Information on the demographics of traumatic and non-traumatic pediatric OHCA survivors (<20 years) was obtained and reported. The patients who survived to discharge (survivors) and those classified as functional survivors were followed up for 1 year for the analysis of newly diagnosed PDDs. The time from discharge to PDD diagnosis was also reported.Results: A total of 2,178 non-traumatic and 288 traumatic OHCA pediatric cases were included. Among the non-traumatic OHCA survivors (n = 374, survival rate = 17.2%), respiratory tract (n = 270, 72.2%), gastrointestinal (n = 187, 50.0%), and neurological diseases (n = 167, 49.1%) were the three most common PDD categories, and in these three categories, the majority of PDDs were atypical/influenza pneumonia, non-infective acute gastroenteritis, and generalized/status epilepsy, respectively. Among the traumatic OHCA survivors (n = 21, survival rate = 7.3%), respiratory tract diseases (n = 17, 81.0%) were the most common, followed by skin or soft tissue (n = 14, 66.7%) diseases. Most functional survivors still suffered from neurological and respiratory tract diseases. Most PDDs, except for skin or soft tissue diseases, were newly diagnosed within the first 3 months after discharge.Conclusions: Respiratory tract (pneumonia), neurological (epilepsy), and skin or soft tissue (dermatitis) diseases were very common among both non-traumatic and traumatic OHCA survivors. More importantly, most PDDs, except for skin or soft tissue diseases, were newly diagnosed within the first 3 months after discharge.
Highlights
Out-of-hospital cardiac arrest (OHCA) in children is rare, and its outcome is very poor
In adult OHCA patients, several health economic studies have noted that the cost of long-term care for non-functional survivors is quite high
Some demographic studies focusing on post-resuscitation evaluations have reported that infections, heart failure, and gastrointestinal hemorrhage were the most common postdischarge diseases (PDDs) in adult OHCA survivors [21, 22]
Summary
Out-of-hospital cardiac arrest (OHCA) in children is rare, and its outcome is very poor. Several studies have reported an OHCA survival rate of 6.7–10.2% and that at most 4% of patients have intact or functional neurological outcomes [1–7]. In adult OHCA patients, several health economic studies have noted that the cost of long-term care for non-functional survivors is quite high. Some demographic studies focusing on post-resuscitation evaluations have reported that infections, heart failure, and gastrointestinal hemorrhage were the most common PDDs in adult OHCA survivors [21, 22]. Postdischarge diseases (PDDs) have been reported for adult survivors of out-of-hospital cardiac arrest (OHCA). The detailed demographics of pediatric OHCA survivors with PDDs are not well-documented, and information regarding functional survivors is limited. We aimed to report detailed information on the PDDs of survivors of traumatic and non-traumatic pediatric OHCA using a national healthcare database
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