Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest.
Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest.
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DOI：
10.1161/circulationaha.108.802678
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发表时间：
2009-03-24
期刊：
影响因子：
37.8
通讯作者：
Resuscitation Outcomes Consortium Investigators
中科院分区：
文献类型：
--
作者：
Atkins DL;Everson-Stewart S;Sears GK;Daya M;Osmond MH;Warden CR;Berg RA;Resuscitation Outcomes Consortium Investigators
基于人口的儿童心脏骤停数据很少，主要来自城市地区。复苏结局联盟（ROC）Epistry-Cardiac Arrest是一项基于人群的院外非创伤性心脏骤停（OHCA）紧急医疗服务（EMS）登记研究。本研究检查了儿童OHCA的年龄分层发生率和结局。我们假设儿童OHCA的出院存活率低于成人OHCA。前瞻性人群队列研究。11个美国和加拿大ROC站点。2005年12月至2007年3月期间，a）接受紧急医疗服务（EMS）提供者的CPR或除颤和/或接受旁观者AED电击或B）无脉搏但未接受EMS复苏的<20岁的患者。患者先验地分为3组：<1岁（婴儿，n = 277），1-11岁（儿童，n = 154）和12-19岁（青少年，n = 193）。儿童OHCA的发生率为8.04/100，000人-年（婴儿为72.71，儿童为3.73，青少年为6.37），成人为126.52。所有儿童OHCA的生存率为6.4%（婴儿为3.3%，儿童为9.1%，青少年为8.9%），成人为4.5%（P=0.03）。与成人相比，儿童存活至出院的未校正比值比（95%CI）为：婴儿0.71（0.37，1.39），儿童2.11（1.21，3.66），青少年2.04（1.24，3.38）。这项研究表明，OHCA在婴儿中的发病率接近在成人中观察到的发病率，但在儿童和青少年中较低。儿童和青少年的出院存活率高于婴儿或成人。
Population-based data for pediatric cardiac arrest are scant and largely from urban areas. The Resuscitation Outcomes Consortium (ROC) Epistry-Cardiac Arrest is a population-based emergency medical services (EMS) registry of out-of-hospital non-traumatic cardiac arrest (OHCA). This study examined age-stratified incidence and outcomes of pediatric OHCA. We hypothesized that survival to hospital discharge is less frequent from pediatric OHCA than adult OHCA. Prospective population-based cohort study. Eleven US and Canadian ROC sites. Persons <20 years who a) receive CPR or defibrillation by emergency medical services (EMS) providers and/or receive bystander AED shock or b) pulseless but receive no EMS resuscitation between December 2005 and March 2007. Patients were a priori stratified into 3 groups: <1 year (infants, n = 277), 1–11 years (children, n = 154), and 12–19 years (adolescents, n = 193). The incidence of pediatric OHCA was 8.04/100,000 person-years (72.71 in infants, 3.73 in children, and 6.37 in adolescents) versus 126.52 for adults. Survival for all pediatric OHCA was 6.4% (3.3% for infants, 9.1% for children and 8.9% for adolescents) versus 4.5% for adults (P=0.03). Unadjusted odds ratio (95% CI) for pediatric survival to discharge compared with adults was 0.71 (0.37, 1.39) for infants, 2.11 (1.21, 3.66) for children, and 2.04 (1.24, 3.38) for adolescents. This study demonstrates that the incidence of OHCA in infants approaches that observed in adults but is lower among children and adolescents. Survival to discharge was more common among children and adolescents than infants or adults.