Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan

Takashi Nagata, Takeru Abe, Eiichiro Noda, Manabu Hasegawa, Makoto Hashizume, Akihito Hagihara

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objectives: To better understand and predict clinical outcomes of paediatric out-of-hospital cardiac arrest (OHCA). Design: A population-based, observational study. Setting: The National Japan Utstein Registry. Participants: 2900 children aged 5-17 years who experienced OHCA and received resuscitation by emergency responders. Signal detection analysis using 17 variables was applied to identify factors associated with OHCA outcomes; the primary endpoint was cerebral performance category (CPC) 1 or 2. A validation study was conducted to verify the model. Results: OHCA was identified as cardiac origin in 706 participants and non-cardiac origin in 2194 participants. Rates of CPC 1 or 2 for cardiac and non-cardiac causes were 20% and 6.4%, respectively. Cardiac origin arrest was categorised following signal detection into six subgroups defined by public automated external defibrillator use, defibrillation by emergency medical service, age, initial ECG rhythm and eye-witness to arrest; the ranges of CPC 1 or 2 in the six subgroups were between 87.5% and 0.7%. Non-cardiac origin arrest was categorised into four subgroups. Bystander rescue breathing was the most significant factor contributing to outcome; additionally, two other factors - eye-witness to arrest and age - were also significant. CPC 1 or 2 rates ranged between 38.5% and 4% across the four subgroups. Rates of CPC 1 or 2 in the validation study did not differ among any subgroup. Conclusions: For children who have OHCA from non-cardiac origin, bystander rescue breathing is mandatory to achieve CPC 1 or 2.

Original languageEnglish
Article numbere003481
JournalBMJ open
Volume4
Issue number2
DOIs
Publication statusPublished - Mar 4 2014

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Out-of-Hospital Cardiac Arrest
Pediatric Hospitals
Japan
Validation Studies
Emergency Responders
Respiration
Defibrillators
Emergency Medical Services
Heart Arrest
Resuscitation
Observational Studies
Registries
Electrocardiography
Population

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan. / Nagata, Takashi; Abe, Takeru; Noda, Eiichiro; Hasegawa, Manabu; Hashizume, Makoto; Hagihara, Akihito.

In: BMJ open, Vol. 4, No. 2, e003481, 04.03.2014.

Research output: Contribution to journalArticle

Nagata, Takashi ; Abe, Takeru ; Noda, Eiichiro ; Hasegawa, Manabu ; Hashizume, Makoto ; Hagihara, Akihito. / Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan. In: BMJ open. 2014 ; Vol. 4, No. 2.
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abstract = "Objectives: To better understand and predict clinical outcomes of paediatric out-of-hospital cardiac arrest (OHCA). Design: A population-based, observational study. Setting: The National Japan Utstein Registry. Participants: 2900 children aged 5-17 years who experienced OHCA and received resuscitation by emergency responders. Signal detection analysis using 17 variables was applied to identify factors associated with OHCA outcomes; the primary endpoint was cerebral performance category (CPC) 1 or 2. A validation study was conducted to verify the model. Results: OHCA was identified as cardiac origin in 706 participants and non-cardiac origin in 2194 participants. Rates of CPC 1 or 2 for cardiac and non-cardiac causes were 20{\%} and 6.4{\%}, respectively. Cardiac origin arrest was categorised following signal detection into six subgroups defined by public automated external defibrillator use, defibrillation by emergency medical service, age, initial ECG rhythm and eye-witness to arrest; the ranges of CPC 1 or 2 in the six subgroups were between 87.5{\%} and 0.7{\%}. Non-cardiac origin arrest was categorised into four subgroups. Bystander rescue breathing was the most significant factor contributing to outcome; additionally, two other factors - eye-witness to arrest and age - were also significant. CPC 1 or 2 rates ranged between 38.5{\%} and 4{\%} across the four subgroups. Rates of CPC 1 or 2 in the validation study did not differ among any subgroup. Conclusions: For children who have OHCA from non-cardiac origin, bystander rescue breathing is mandatory to achieve CPC 1 or 2.",
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