Outcome of out-of-hospital cardiopulmonary arrest in children: A multicenter cohort study

Özet

The aim of this study was to evaluate the demographic characteristics ofchildren who experienced out-of-hospital cardiopulmonary arrest (CPA), andto assess the impact of the bystander cardiopulmonary resuscitation (CPR) onthe survival rate of witnessed arrests and the effects of the arrest and CPRdurations on the neurological outcomes. This multicenter, retrospective studyincluded a total of 182 patients who underwent CPR for out-of-hospital CPAbetween January 2008 and December 2012 at six centers in Ankara, Turkey.The median [interquartile range (IQR)] age was 22 (5-54) months; 60.4% ofthe patients were males, and 44% were younger than one year of age. Thewitnessed arrest rate was 75.8% (138/182) and the rate of bystander CPRwas 13.9% (13/93). In these patients the rate of the return of spontaneouscirculation (ROSC) was higher (76.9%). Following resuscitation in the patientsfor whom the spontaneous circulation was able to be returned, the median(IQR) duration of arrest was 5 (1- 15) min, while it was 15 (5-40) min forthe remaining patients (p<0.001). The ROSC rate was 94.9% in patientswho underwent CPR for less than 20 min and 22% in patients requiringCPR longer than 20 min (p<0.001). Survival to hospital discharge was14.3%. Of these patients, 57.7% experienced neurological disability. The shortduration of an arrest and the presence of CPR are both critical for survival.We suggest that a witness to the CPA, performing early and efficient CPR,yields better results.