1University of Washington, School of Medicine, Seattle, WA. 2Department of Emergency Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI. 3Department of Pediatrics, Seattle Children's Hospital, Seattle, WA. 4Paris Cardiovascular Research Center, Paris Descartes University, Paris, France.
Pediatr Crit Care Med. 2013 Oct;14(8):755-60. doi: 10.1097/PCC.0b013e31829763e2.
Pediatric out-of-hospital cardiac arrest is an uncommon event with measurable short-term survival to hospital discharge. For those who survive to hospital discharge, little is known regarding duration of survival. We sought to evaluate the arrest circumstances and long-term survival of pediatric patients who experienced an out-of-hospital cardiac arrest and survived to hospital discharge.
Retrospective cohort study
King County, WA Emergency Medical Service Catchment and Quaternary Care Children's Hospital
Persons less than 19 years old who had an out-of-hospital cardiac arrest and were discharged alive from the hospital between 1976 and 2007.
None.
During the study period, 1,683 persons less than 19 years old were treated for pediatric out-of-hospital cardiac arrest in the study community, with 91 patients surviving to hospital discharge. Of these 91 survivors, 20 (22%) subsequently died during 1449 person-years of follow-up. Survival following hospital discharge was 92% at 1 year, 86% at 5 years, and 77% at 20 years. Compared to those who subsequently died, long-term survivors were more likely at the time of discharge to be older (mean age, 8 vs 1 yr), had a witnessed arrest (83% vs 56%), presented with a shockable rhythm (40% vs 10%), and had a favorable Pediatric Cerebral Performance Category of 1 or 2 (67% vs 0%).
In this population-based cohort study evaluating the long-term outcome of pediatric survivors of out-of-hospital cardiac arrest, we observed that long-term survival was generally favorable. Age, arrest characteristics, and functional status at hospital discharge were associated with prognosis. These findings support efforts to improve pediatric resuscitation, stabilization, and convalescent care.
儿科院外心脏骤停是一种罕见的事件，可测量到短期存活至出院。对于那些存活至出院的患者，关于存活时间知之甚少。我们试图评估经历院外心脏骤停并存活至出院的儿科患者的急救情况和长期生存情况。
回顾性队列研究
华盛顿州金县紧急医疗服务收容区和四级儿童医院
1976 年至 2007 年间，19 岁以下在院外发生心脏骤停并从医院存活出院的患者。
无
在研究期间，研究社区有 1683 名 19 岁以下的人因儿科院外心脏骤停接受治疗，91 名患者存活至出院。在这 91 名幸存者中，20 人（22%）在 1449 人年的随访中随后死亡。出院后的生存率为 1 年时为 92%，5 年时为 86%，20 年时为 77%。与随后死亡的患者相比，长期幸存者在出院时更有可能年龄较大（平均年龄 8 岁比 1 岁）、有目击者见证的骤停（83%比 56%）、呈现可除颤节律（40%比 10%），以及具有良好的儿科脑功能表现分类 1 或 2（67%比 0%）。
在这项基于人群的队列研究中，我们评估了院外心脏骤停后儿科幸存者的长期结局，观察到长期生存情况总体良好。年龄、急救特征和出院时的功能状态与预后相关。这些发现支持努力改善儿科复苏、稳定和康复护理。
