Incidence, characteristics, and outcomes of pediatric out-of-hospital cardiac arrest in nursery schools and kindergartens in Japan
Incidence, characteristics, and outcomes of pediatric out-of-hospital cardiac arrest in nursery schools and kindergartens in Japan
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DOI：
10.1016/j.jjcc.2020.06.003
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发表时间：
2020-12-01
影响因子：
2.5
通讯作者：
Kitamura, Yuri
中科院分区：
文献类型：
--
作者：
Kiyohara, Kosuke;Kitamura, Tetsuhisa;Kitamura, Yuri
背景：更好地了解发生在幼儿园和幼儿园的儿科院外心脏骤停（OHCA）的流行病学对于建立基于证据的预防策略和改善结果是必不可少的。本研究旨在描述在经认证的托儿所和幼儿园中发生的儿童职业职业倦怠的发生率、特征和结果。方法：在学校停止和预防心脏骤停、伤害和创伤（SPIRITS）是一项研究，旨在构建和分析日本学校环境中发生的儿童ohca的全国登记。使用SPIRITS登记处的数据，我们评估了2008年4月至2016年12月间在认证托儿所/幼儿园发生的儿科ohca的发生率、特征和结局。结果：研究期间共确诊OHCA患者37例，其中幼儿园31例，幼儿园6例。总发病率为每年每10万名儿童0.13例。在37例患者中，57%（21/37）的患者在午睡时发生了OHCA， 35%（13/37）的患者在旁观者的见证下经历了OHCA。虽然24%（9/37）的病例中旁观者使用了公共通道的自动体外除颤器垫，但实际上只有1例患者接受了除颤。总体而言，OHCA术后1个月生存率为19%（7/37）。在非医学来源的OHCA患者中，60%（3/5）的患者因窒息而骤停，60%（3/5）因溺水而骤停，100%（1/1）因头部损伤而骤停。相比之下，在医学来源的OHCA患者中，没有患者在1个月的神经系统预后良好，例如假定的心脏来源（0/17）、婴儿猝死综合征（0/6）、急性病毒性心肌炎（0/1）、呼吸系统疾病（0/1）和心室颤动（0/1）。结论：在这一人群中，大多数发生在认证托儿所/幼儿园的儿童OHCA为非室颤性心律，其医学来源的OHCA后的预后较差。(C) 2020由Elsevier Ltd代表日本心脏病学院出版。
Background: A better understanding of the epidemiology of pediatric out-of-hospital cardiac arrest (OHCA) occurring in nursery schools and kindergartens is indispensable to establish an evidence-based strategy for prevention and improved outcomes. This study aimed to describe the incidence, characteristics, and outcomes of pediatric OHCAs that occurred in certified nursery schools and kindergartens.Methods: Stop and Prevent cardiac aRrest, Injury, and Trauma in Schools (SPIRITS) is a study to construct and analyze a nationwide registry of pediatric OHCAs occurring in school settings in Japan. Using data from the SPIRITS registry, we assessed the incidence, characteristics, and outcomes of pediatric OHCAs that occurred in certified nursery schools/kindergartens between April 2008 and December 2016.Results: During the study period, 37 OHCA patients (31 in certified nursery schools and 6 in kindergartens) were confirmed. The overall incidence rate was 0.13 per 100,000 children per year. Among 37 patients, 57% (21/37) had an OHCA while napping and 35% (13/37) experienced OHCA that was witnessed by bystanders. Although public-access automated external defibrillator pads were applied by bystanders in 24% (9/37) of cases, only 1 patient actually received defibrillation. Overall, the proportion of 1-month survival with favorable neurological outcomes after OHCA was 19% (7/37). Among those with OHCA of non-medical origins, 60% (3/5) of patients experienced arrest caused by suffocation, 60% (3/5) by drowning, and 100% (1/1) by head injury. In contrast, no patient had 1-month favorable neurological outcomes among those with OHCA of medical origins such as presumed cardiac origin (0/17), sudden infant death syndrome (0/6), acute viral myocarditis (0/1), respiratory disease (0/1), and ventricular fibrillation (0/1).Conclusions: In this population, the majority of pediatric OHCAs occurring in certified nursery schools/kindergartens had non-ventricular fibrillation rhythm, and their outcomes after OHCA of medical origin were poor. (C) 2020 Published by Elsevier Ltd on behalf of Japanese College of Cardiology.