Clinical Research
Heart Rhythm Disorders
Incidence, Causes, and Outcomes of Out-of-Hospital Cardiac Arrest in Children: A Comprehensive, Prospective, Population-Based Study in the Netherlands

https://doi.org/10.1016/j.jacc.2010.11.054Get rights and content
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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.

Key Words

cardiopulmonary resuscitation
children
epidemiology
out-of-hospital cardiac arrest

Abbreviations and Acronyms

AED
automated external defibrillator
CPR
cardiopulmonary resuscitation
EMS
emergency medical services
ICD-10
International Classification of Diseases-10th Revision
OHCA
out-of-hospital cardiac arrest
VF
ventricular fibrillation
VT
ventricular tachycardia

Cited by (0)

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.