Department of Emergency Medicine, Osaka Medical College, Takatsuki City, Osaka 569-8686, Japan.
Pediatrics. 2011 Oct;128(4):e812-20. doi: 10.1542/peds.2010-3886. Epub 2011 Sep 2.
We assessed out-of-hospital cardiac arrests (OHCAs) for various pediatric age groups.
This prospective, population-based, observational study included all emergency medical service-treated OHCAs in Osaka, Japan, between 1999 and 2006 (excluding 2004). Patients were grouped as adults (>17 years), infants (<1 year), younger children (1-4 years), older children (5-12 years), and adolescents (13-17 years). The primary outcome measure was 1-month survival with favorable neurologic outcome.
Of 950 pediatric OHCAs, resuscitations were attempted for 875 patients (92%; 347 infants, 203 younger children, 135 older children, and 190 adolescents). The overall incidence of nontraumatic pediatric OHCAs was 7.3 cases per 100 000 person-years, compared with 64.7 cases per 100 000 person-years for adults and 65.5 cases per 100 000 person-years for infants. Most infant OHCAs occurred in homes (93%) and were not witnessed (90%). Adolescent OHCAs often occurred outside the home (45%), were witnessed by bystanders (37%), and had shockable rhythms (18%). One-month survival was more common after nontraumatic pediatric OHCAs than adult OHCAs (8% [56 of 740 patients] vs 5% [1677 of 33 091 patients]; adjusted odds ratio: 2.26 [95% confidence interval: 1.63-3.13]). One-month survival with favorable neurologic outcome was more common among children than adults (3% [21 of 740 patients] vs 2% [648 of 33 091 patients]; adjusted odds ratio: 2.46 [95% confidence interval: 1.45-4.18]). Rates of 1-month survival with favorable neurologic outcome were 1% for infants, 2% for younger children, 2% for older children, and 11% for adolescents.
Survival and favorable neurologic outcome at 1 month were more common after pediatric OHCAs than adult OHCAs.
我们评估了不同儿科年龄组的院外心脏骤停（OHCA）。
本前瞻性、基于人群的观察性研究纳入了 1999 年至 2006 年期间日本大阪所有接受急救医疗服务的 OHCA（不包括 2004 年）。患者分为成人（>17 岁）、婴儿（<1 岁）、幼儿（1-4 岁）、大龄儿童（5-12 岁）和青少年（13-17 岁）。主要结局指标为 1 个月时具有良好神经功能结局的生存率。
在 950 例儿科 OHCA 中，对 875 例患者进行了复苏尝试（92%；347 例婴儿，203 例幼儿，135 例大龄儿童，190 例青少年）。非创伤性儿科 OHCA 的总发生率为每 100000 人年 7.3 例，而成人和婴儿的发生率分别为每 100000 人年 64.7 例和 65.5 例。大多数婴儿 OHCA 发生在家庭中（93%）且未被目击（90%）。青少年 OHCA 常发生在家庭外（45%），由旁观者目击（37%），且具有可除颤节律（18%）。非创伤性儿科 OHCA 后 1 个月生存率高于成人 OHCA（8%[740 例患者中的 56 例]与 5%[33091 例患者中的 1677 例]；调整后的优势比：2.26[95%置信区间：1.63-3.13]）。儿童 1 个月生存率优于成人（3%[740 例患者中的 21 例]与 2%[33091 例患者中的 648 例]；调整后的优势比：2.46[95%置信区间：1.45-4.18]）。1 个月时具有良好神经功能结局的生存率分别为婴儿 1%、幼儿 2%、大龄儿童 2%和青少年 11%。
儿科 OHCA 后生存率和 1 个月时的良好神经功能结局更为常见。
