Outcomes of nontraumatic pediatric versus adult out-of-hospital cardiac arrest: a nationwide multicenter registry study

Purpose: This study was performed to investigate the outcomes of pediatric (<18 years) nontraumatic out-of-hospital cardiac arrest (OHCA) compared with adult nontraumatic OHCA.Methods: This pilot study was based on prospectively collected data from the Korean Cardiac Arrest Research Consortium registry, a South Korean nationwide emergency department-based registry involving 33 hospitals.Survival to admission, survival to hospital discharge, and good neurologic outcomes (Cerebral Performance Category 1-2) at discharge were compared between pediatric and adult cases.Multivariable logistic regression analysis was performed to identify prognostic factors for survival to discharge in pediatric OHCA.Results: Of 9,521 patients with nontraumatic OHCA, we analyzed 182 pediatric and 8,871 adult patients.Frequencies of defibrillation and advanced airway management performed by the Korean national 119 emergency medical service providers were lower in the pediatric patients, whereas the median call-to-hospital arrival time was shorter (27.5 minutes [interquartile range, 21.3-32.8]vs. 30.0minutes [25.0-38.0];P <0.001).Conventional cardiopulmonary resuscitation was performed more frequently in the pediatric patients than in the adults (9.3% vs. 4.2%; P = 0.005).No group difference was found in any of the 3 outcomes.In the multivariable logistic regression analysis, the initial shockable rhythm (adjusted odds ratio, 9.82; 95% confidence interval, 1.83-52.81)and presence of a witness (3.02; 1.01-9.01)were significant prognostic factors for survival to discharge in the pediatric patients with nontraumatic OHCA. Conclusion:The outcomes of pediatric nontraumatic OHCA in Korea are comparable to those observed in the adult cases.Pediatric patients with nontraumatic OHCA may have more favorable outcomes if the arrest is witnessed or the initial rhythm is shockable.