Department of Public Health, Health Management and Policy, Nara Medical University School of Medicine, Nara, Japan.
Pediatr Crit Care Med. 2013 Feb;14(2):130-6. doi: 10.1097/PCC.0b013e31827129b3.
There is a paucity of data examining nationwide population-based incidences and outcomes of pediatric out-of-hospital cardiac arrest. The objective of this study is to describe the detailed characteristics of pediatric out-of-hospital cardiac arrest by scholastic age category and to evaluate the impact of bystander cardiopulmonary resuscitation and public access-automated external defibrillators on the 1-month survival and favorable neurological status of pediatric out-of-hospital cardiac arrest patients.
A nationwide, population-based, observational study.
Nationwide emergency medical system in Japan.
Out-of-hospital cardiac arrest patients aged ≤ 18 yr.
We identified 7,624 pediatric out-of-hospital cardiac arrest patients (≤ 18 yr old) from a nationwide population-based out-of-hospital cardiac arrest database in Japan from 2005 to 2008 and stratified them into five categories by scholastic age. The overall rates of 1-month survival and favorable neurological outcomes were 11.0% and 5.1%, respectively. Bystander cardiopulmonary resuscitation resulted in a significant improvement in both 1-month survival (odds ratio 2.81; 95% confidence interval 2.30-3.44) and favorable neurological outcomes (odds ratio 4.55; 95% confidence interval 3.35-6.18). Performing public access-automated external defibrillators had a significant effect on the 1-month survival rate (odds ratio 3.51; 95% confidence interval 1.81-6.81) and favorable neurological outcomes (odds ratio 5.13; 95% confidence interval 2.64-9.96).
This study demonstrated that bystander cardiopulmonary resuscitation and public access-automated external defibrillators had a significant impact on the outcomes of pediatric out-of-hospital cardiac arrest. The improved survival associated with bystander cardiopulmonary resuscitation and public access-automated external defibrillators are clinically important and are of major public health importance for school-aged out-of-hospital cardiac arrest patients.
目前缺乏关于儿科院外心脏骤停的全国性基于人群的发病率和结局的数据。本研究的目的是描述按学业年龄分类的儿科院外心脏骤停的详细特征，并评估旁观者心肺复苏和公众获取自动体外除颤器对儿科院外心脏骤停患者 1 个月生存率和良好神经状态的影响。
一项全国性、基于人群的观察性研究。
日本全国性急救医疗系统。
年龄≤18 岁的院外心脏骤停患者。
我们从日本 2005 年至 2008 年的全国性院外心脏骤停数据库中确定了 7624 例儿科院外心脏骤停患者（≤18 岁），并按学业年龄将其分为 5 组。1 个月生存率和良好神经结局的总体发生率分别为 11.0%和 5.1%。旁观者心肺复苏显著提高了 1 个月生存率（优势比 2.81；95%置信区间 2.30-3.44）和良好的神经结局（优势比 4.55；95%置信区间 3.35-6.18）。实施公众获取自动体外除颤器对 1 个月生存率（优势比 3.51；95%置信区间 1.81-6.81）和良好的神经结局（优势比 5.13；95%置信区间 2.64-9.96）有显著影响。
本研究表明，旁观者心肺复苏和公众获取自动体外除颤器对儿科院外心脏骤停的结局有显著影响。旁观者心肺复苏和公众获取自动体外除颤器带来的生存率提高具有重要的临床意义，对学龄期院外心脏骤停患者具有重要的公共卫生意义。
