Unchanged pediatric out-of-hospital cardiac arrest incidence and survival rates with regional variation in North America

Ericka L. Fink, David K. Prince, Jonathan R. Kaltman, Dianne L. Atkins, Michael Austin, Craig Warden, Jamie Hutchison, Mohamud Ramzan Daya, Scott Goldberg, Heather Herren, Janice A. Tijssen, James Christenson, Christian Vaillancourt, Ronna Miller, Robert H. Schmicker, Clifton W. Callaway

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Aim Outcomes for pediatric out-of-hospital cardiac arrest (OHCA) are poor. Our objective was to determine temporal trends in incidence and mortality for pediatric OHCA. Methods Adjusted incidence and hospital mortality rates of pediatric non-traumatic OHCA patients from 2007–2012 were analyzed using the 9 region Resuscitation Outcomes Consortium—Epidemiological Registry (ROC-Epistry) database. Children were divided into 4 age groups: perinatal (<3 days), infants (3 days–1 year), children (1–11 years), and adolescents (12–19 years). ROC regions were analyzed post-hoc. Results We studied 1738 children with OHCA. The age- and sex-adjusted incidence rate of OHCA was 8.3 per 100,000 person-years (75.3 for infants vs. 3.7 for children and 6.3 for adolescents, per 100,000 person-years, p < 0.001). Incidence rates differed by year (p < 0.001) without overall linear trend. Annual survival rates ranged from 6.7–10.2%. Survival was highest in the perinatal (25%) and adolescent (17.3%) groups. Stratified by age group, survival rates over time were unchanged (all p > 0.05) but there was a non-significant linear trend (1.3% increase) in infants. In the multivariable logistic regression analysis, infants, unwitnessed event, initial rhythm of asystole, and region were associated with worse survival, all p < 0.001. Survival by region ranged from 2.6–14.7%. Regions with the highest survival had more cases of EMS-witnessed OHCA, bystander CPR, and increased EMS-defibrillation (all p < 0.05). Conclusions Overall incidence and survival of children with OHCA in ROC regions did not significantly change over a recent 5 year period. Regional variation represents an opportunity for further study to improve outcomes.

Original languageEnglish (US)
Pages (from-to)121-128
Number of pages8
JournalResuscitation
Volume107
DOIs
StatePublished - Oct 1 2016

Fingerprint

Out-of-Hospital Cardiac Arrest
Pediatric Hospitals
North America
Survival Rate
Incidence
Survival
Mortality
Cardiopulmonary Resuscitation
Hospital Mortality
Heart Arrest
Resuscitation
Registries
Age Groups
Logistic Models
Regression Analysis
Databases
Pediatrics

Keywords

  • Cardiac arrest
  • Epidemiology
  • Outcomes
  • Pediatric
  • Resuscitation

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this

Unchanged pediatric out-of-hospital cardiac arrest incidence and survival rates with regional variation in North America. / Fink, Ericka L.; Prince, David K.; Kaltman, Jonathan R.; Atkins, Dianne L.; Austin, Michael; Warden, Craig; Hutchison, Jamie; Daya, Mohamud Ramzan; Goldberg, Scott; Herren, Heather; Tijssen, Janice A.; Christenson, James; Vaillancourt, Christian; Miller, Ronna; Schmicker, Robert H.; Callaway, Clifton W.

In: Resuscitation, Vol. 107, 01.10.2016, p. 121-128.

Research output: Contribution to journalArticle

Fink, EL, Prince, DK, Kaltman, JR, Atkins, DL, Austin, M, Warden, C, Hutchison, J, Daya, MR, Goldberg, S, Herren, H, Tijssen, JA, Christenson, J, Vaillancourt, C, Miller, R, Schmicker, RH & Callaway, CW 2016, 'Unchanged pediatric out-of-hospital cardiac arrest incidence and survival rates with regional variation in North America', Resuscitation, vol. 107, pp. 121-128. https://doi.org/10.1016/j.resuscitation.2016.07.244
Fink, Ericka L. ; Prince, David K. ; Kaltman, Jonathan R. ; Atkins, Dianne L. ; Austin, Michael ; Warden, Craig ; Hutchison, Jamie ; Daya, Mohamud Ramzan ; Goldberg, Scott ; Herren, Heather ; Tijssen, Janice A. ; Christenson, James ; Vaillancourt, Christian ; Miller, Ronna ; Schmicker, Robert H. ; Callaway, Clifton W. / Unchanged pediatric out-of-hospital cardiac arrest incidence and survival rates with regional variation in North America. In: Resuscitation. 2016 ; Vol. 107. pp. 121-128.
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abstract = "Aim Outcomes for pediatric out-of-hospital cardiac arrest (OHCA) are poor. Our objective was to determine temporal trends in incidence and mortality for pediatric OHCA. Methods Adjusted incidence and hospital mortality rates of pediatric non-traumatic OHCA patients from 2007–2012 were analyzed using the 9 region Resuscitation Outcomes Consortium—Epidemiological Registry (ROC-Epistry) database. Children were divided into 4 age groups: perinatal (<3 days), infants (3 days–1 year), children (1–11 years), and adolescents (12–19 years). ROC regions were analyzed post-hoc. Results We studied 1738 children with OHCA. The age- and sex-adjusted incidence rate of OHCA was 8.3 per 100,000 person-years (75.3 for infants vs. 3.7 for children and 6.3 for adolescents, per 100,000 person-years, p < 0.001). Incidence rates differed by year (p < 0.001) without overall linear trend. Annual survival rates ranged from 6.7–10.2{\%}. Survival was highest in the perinatal (25{\%}) and adolescent (17.3{\%}) groups. Stratified by age group, survival rates over time were unchanged (all p > 0.05) but there was a non-significant linear trend (1.3{\%} increase) in infants. In the multivariable logistic regression analysis, infants, unwitnessed event, initial rhythm of asystole, and region were associated with worse survival, all p < 0.001. Survival by region ranged from 2.6–14.7{\%}. Regions with the highest survival had more cases of EMS-witnessed OHCA, bystander CPR, and increased EMS-defibrillation (all p < 0.05). Conclusions Overall incidence and survival of children with OHCA in ROC regions did not significantly change over a recent 5 year period. Regional variation represents an opportunity for further study to improve outcomes.",
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T1 - Unchanged pediatric out-of-hospital cardiac arrest incidence and survival rates with regional variation in North America

AU - Fink, Ericka L.

AU - Prince, David K.

AU - Kaltman, Jonathan R.

AU - Atkins, Dianne L.

AU - Austin, Michael

AU - Warden, Craig

AU - Hutchison, Jamie

AU - Daya, Mohamud Ramzan

AU - Goldberg, Scott

AU - Herren, Heather

AU - Tijssen, Janice A.

AU - Christenson, James

AU - Vaillancourt, Christian

AU - Miller, Ronna

AU - Schmicker, Robert H.

AU - Callaway, Clifton W.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Aim Outcomes for pediatric out-of-hospital cardiac arrest (OHCA) are poor. Our objective was to determine temporal trends in incidence and mortality for pediatric OHCA. Methods Adjusted incidence and hospital mortality rates of pediatric non-traumatic OHCA patients from 2007–2012 were analyzed using the 9 region Resuscitation Outcomes Consortium—Epidemiological Registry (ROC-Epistry) database. Children were divided into 4 age groups: perinatal (<3 days), infants (3 days–1 year), children (1–11 years), and adolescents (12–19 years). ROC regions were analyzed post-hoc. Results We studied 1738 children with OHCA. The age- and sex-adjusted incidence rate of OHCA was 8.3 per 100,000 person-years (75.3 for infants vs. 3.7 for children and 6.3 for adolescents, per 100,000 person-years, p < 0.001). Incidence rates differed by year (p < 0.001) without overall linear trend. Annual survival rates ranged from 6.7–10.2%. Survival was highest in the perinatal (25%) and adolescent (17.3%) groups. Stratified by age group, survival rates over time were unchanged (all p > 0.05) but there was a non-significant linear trend (1.3% increase) in infants. In the multivariable logistic regression analysis, infants, unwitnessed event, initial rhythm of asystole, and region were associated with worse survival, all p < 0.001. Survival by region ranged from 2.6–14.7%. Regions with the highest survival had more cases of EMS-witnessed OHCA, bystander CPR, and increased EMS-defibrillation (all p < 0.05). Conclusions Overall incidence and survival of children with OHCA in ROC regions did not significantly change over a recent 5 year period. Regional variation represents an opportunity for further study to improve outcomes.

AB - Aim Outcomes for pediatric out-of-hospital cardiac arrest (OHCA) are poor. Our objective was to determine temporal trends in incidence and mortality for pediatric OHCA. Methods Adjusted incidence and hospital mortality rates of pediatric non-traumatic OHCA patients from 2007–2012 were analyzed using the 9 region Resuscitation Outcomes Consortium—Epidemiological Registry (ROC-Epistry) database. Children were divided into 4 age groups: perinatal (<3 days), infants (3 days–1 year), children (1–11 years), and adolescents (12–19 years). ROC regions were analyzed post-hoc. Results We studied 1738 children with OHCA. The age- and sex-adjusted incidence rate of OHCA was 8.3 per 100,000 person-years (75.3 for infants vs. 3.7 for children and 6.3 for adolescents, per 100,000 person-years, p < 0.001). Incidence rates differed by year (p < 0.001) without overall linear trend. Annual survival rates ranged from 6.7–10.2%. Survival was highest in the perinatal (25%) and adolescent (17.3%) groups. Stratified by age group, survival rates over time were unchanged (all p > 0.05) but there was a non-significant linear trend (1.3% increase) in infants. In the multivariable logistic regression analysis, infants, unwitnessed event, initial rhythm of asystole, and region were associated with worse survival, all p < 0.001. Survival by region ranged from 2.6–14.7%. Regions with the highest survival had more cases of EMS-witnessed OHCA, bystander CPR, and increased EMS-defibrillation (all p < 0.05). Conclusions Overall incidence and survival of children with OHCA in ROC regions did not significantly change over a recent 5 year period. Regional variation represents an opportunity for further study to improve outcomes.

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KW - Epidemiology

KW - Outcomes

KW - Pediatric

KW - Resuscitation

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