Author + information
- Received August 26, 2010
- Revision received October 14, 2010
- Accepted November 8, 2010
- Published online May 3, 2011.
- Abdennasser Bardai, MD⁎,
- Jocelyn Berdowski, PhD, MSE†,
- Christian van der Werf, MD⁎,
- Marieke T. Blom, MA⁎,
- Manon Ceelen, PhD‡,
- Irene M. van Langen, MD, PhD§,
- Jan G.P. Tijssen, PhD†,
- Arthur A.M. Wilde, MD, PhD⁎,
- Rudolph W. Koster, MD, PhD† and
- Hanno L. Tan, MD, PhD⁎,⁎ ()
- ↵⁎Reprints requests and correspondence:
Dr. Hanno L. Tan, Heart Failure Research Center, Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
Objectives This study sought to determine comprehensively the incidence of pediatric out-of-hospital cardiac arrest (OHCA) and its contribution to total pediatric mortality, the causes of pediatric OHCA, and the outcome of resuscitation of pediatric OHCA patients.
Background There is a paucity of complete studies on incidence, causes, and outcomes of pediatric OHCA.
Methods In this prospective, population-based study, OHCA victims younger than age 21 years in 1 province of the Netherlands were registered through both emergency medical services and coroners over a period of 4.3 years. Death certificate data on total pediatric mortality, survival status, and neurological outcome at hospital discharge also were obtained.
Results With a total mortality of 923 during the study period and 233 victims of OHCA (including 221 who died and 12 who survived), OHCA caused 24% (221 of 923) of total pediatric mortality. Natural causes of OHCA amounted to 115 (49%) cases, with cardiac causes being most prevalent (n = 90, 39%). The incidence of pediatric OHCA was 9.0 per 100,000 pediatric person-years (95% confidence interval: 7.8 to 10.3), whereas the incidence of pediatric OHCA from cardiac causes was 3.2 (95% confidence interval: 2.5 to 3.9). Of 51 resuscitated patients, 12 (24%) survived; among survivors, 10 (83%) had a neurologically intact outcome.
Conclusions Out-of-hospital cardiac arrest accounts for a significant proportion of pediatric mortality, and cardiac causes are the most prevalent causes of OHCA. The vast majority of OHCA survivors have a neurologically intact outcome.
Dr. Bardai was supported by the Netherlands Organization for Scientific Research (NWO, grant Mozaiek 017.003.084). Drs. Wilde and van Langen were supported by Zorg Onderzoek Nederland Medische Wetenschappen (Zon-MW, grant 120610013). Dr. Wilde was supported by Fondation Leducq Trans-Atlantic Network of Excellence, Preventing Sudden Death (grant 05-CVD-01). Dr. Koster was supported by the Netherlands Heart Foundation (grant 2006B179) and Physio Control, Inc. Dr. Tan was supported by the Netherlands Organization for Scientific Research (NWO, grant ZonMW Vici 918.86.616) and the Dutch Medicines Evaluation Board (MEB/CBG). All other authors have reported that they have no relationships to disclose. Drs. Bardai, Berdowski, and van der Werf contributed equally to this work.
- Received August 26, 2010.
- Revision received October 14, 2010.
- Accepted November 8, 2010.
- American College of Cardiology Foundation