Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan

Takashi Nagata, Takeru Abe, Eiichiro Noda, Manabu Hasegawa, Makoto Hashizume, Akihito Hagihara

    Research output: Contribution to journalArticle

    14 Citations (Scopus)

    Abstract

    Objectives: To better understand and predict clinical outcomes of paediatric out-of-hospital cardiac arrest (OHCA). Design: A population-based, observational study. Setting: The National Japan Utstein Registry. Participants: 2900 children aged 5-17 years who experienced OHCA and received resuscitation by emergency responders. Signal detection analysis using 17 variables was applied to identify factors associated with OHCA outcomes; the primary endpoint was cerebral performance category (CPC) 1 or 2. A validation study was conducted to verify the model. Results: OHCA was identified as cardiac origin in 706 participants and non-cardiac origin in 2194 participants. Rates of CPC 1 or 2 for cardiac and non-cardiac causes were 20% and 6.4%, respectively. Cardiac origin arrest was categorised following signal detection into six subgroups defined by public automated external defibrillator use, defibrillation by emergency medical service, age, initial ECG rhythm and eye-witness to arrest; the ranges of CPC 1 or 2 in the six subgroups were between 87.5% and 0.7%. Non-cardiac origin arrest was categorised into four subgroups. Bystander rescue breathing was the most significant factor contributing to outcome; additionally, two other factors - eye-witness to arrest and age - were also significant. CPC 1 or 2 rates ranged between 38.5% and 4% across the four subgroups. Rates of CPC 1 or 2 in the validation study did not differ among any subgroup. Conclusions: For children who have OHCA from non-cardiac origin, bystander rescue breathing is mandatory to achieve CPC 1 or 2.

    Original languageEnglish
    Article numbere003481
    JournalBMJ Open
    Volume4
    Issue number2
    DOIs
    Publication statusPublished - 2014

    Fingerprint

    Out-of-Hospital Cardiac Arrest
    Pediatric Hospitals
    Japan
    Validation Studies
    Emergency Responders
    Respiration
    Defibrillators
    Emergency Medical Services
    Heart Arrest
    Resuscitation
    Observational Studies
    Registries
    Electrocardiography
    Population

    ASJC Scopus subject areas

    • Medicine(all)

    Cite this

    Nagata, T., Abe, T., Noda, E., Hasegawa, M., Hashizume, M., & Hagihara, A. (2014). Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan. BMJ Open, 4(2), [e003481]. https://doi.org/10.1136/bmjopen-2013-003481

    Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan. / Nagata, Takashi; Abe, Takeru; Noda, Eiichiro; Hasegawa, Manabu; Hashizume, Makoto; Hagihara, Akihito.

    In: BMJ Open, Vol. 4, No. 2, e003481, 2014.

    Research output: Contribution to journalArticle

    Nagata, T, Abe, T, Noda, E, Hasegawa, M, Hashizume, M & Hagihara, A 2014, 'Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan', BMJ Open, vol. 4, no. 2, e003481. https://doi.org/10.1136/bmjopen-2013-003481
    Nagata, Takashi ; Abe, Takeru ; Noda, Eiichiro ; Hasegawa, Manabu ; Hashizume, Makoto ; Hagihara, Akihito. / Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan. In: BMJ Open. 2014 ; Vol. 4, No. 2.
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    abstract = "Objectives: To better understand and predict clinical outcomes of paediatric out-of-hospital cardiac arrest (OHCA). Design: A population-based, observational study. Setting: The National Japan Utstein Registry. Participants: 2900 children aged 5-17 years who experienced OHCA and received resuscitation by emergency responders. Signal detection analysis using 17 variables was applied to identify factors associated with OHCA outcomes; the primary endpoint was cerebral performance category (CPC) 1 or 2. A validation study was conducted to verify the model. Results: OHCA was identified as cardiac origin in 706 participants and non-cardiac origin in 2194 participants. Rates of CPC 1 or 2 for cardiac and non-cardiac causes were 20{\%} and 6.4{\%}, respectively. Cardiac origin arrest was categorised following signal detection into six subgroups defined by public automated external defibrillator use, defibrillation by emergency medical service, age, initial ECG rhythm and eye-witness to arrest; the ranges of CPC 1 or 2 in the six subgroups were between 87.5{\%} and 0.7{\%}. Non-cardiac origin arrest was categorised into four subgroups. Bystander rescue breathing was the most significant factor contributing to outcome; additionally, two other factors - eye-witness to arrest and age - were also significant. CPC 1 or 2 rates ranged between 38.5{\%} and 4{\%} across the four subgroups. Rates of CPC 1 or 2 in the validation study did not differ among any subgroup. Conclusions: For children who have OHCA from non-cardiac origin, bystander rescue breathing is mandatory to achieve CPC 1 or 2.",
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