Department of Paramedicine, Monash University, Clayton, Victoria, Australia.
Queensland Ambulance Service, Brisbane, Queensland, Australia.
Prehosp Emerg Care. 2023;27(6):718-727. doi: 10.1080/10903127.2022.2096159. Epub 2022 Jul 22.
To identify the epidemiological patterns of pediatric out-of-hospital cardiac arrests (OHCA) in Queensland, Australia and to investigate associations between patient variables and prehospital outcome.
Included were pediatric (>4 days-18 years) OHCA patients attended by paramedics in the state of Queensland (Australia) between January 2009 and December 2019. Patient and arrest characteristics were described. Factors associated with return of spontaneous circulation (ROSC) on hospital arrival were investigated.
A total of 1,612 pediatric patients were included; 611 were deceased prior to paramedic arrival and 1,001 received resuscitation attempts by paramedics. Approximately one quarter (26.8%) of resuscitation-attempted patients achieved ROSC on hospital arrival. Most arrests (49.7%) were due to medical causes. Arrests due to trauma had the lowest rate of ROSC on hospital arrival (9.6%), whereas those due to drug overdose had the highest rate (40%). Patients in rural areas had a lower rate of ROSC on hospital arrival than those in metropolitan areas (20.7% vs 32.5%, p < 0.001). The median response interval to all OHCA patients was 8 minutes. Trauma was considerably more prevalent in rural areas than in metropolitan areas, while all other etiologies were comparable. Older pediatric age groups had higher rates of ROSC on hospital arrival than infants, particularly early adolescents (39.4% vs. 14.9%, p = 0.001). Etiology, age, bystander witness, shockable initial rhythm, and geographic locality factors were independently associated with ROSC on hospital arrival.
Approximately a quarter of pediatric prehospital OHCA achieved ROSC on hospital arrival. Prehospital outcome differs according to patient cohort and is associated with diverse patient demographic variables.
识别澳大利亚昆士兰州儿科院外心脏骤停（OHCA）的流行病学模式，并研究患者变量与院前结局之间的关联。
纳入 2009 年 1 月至 2019 年 12 月期间在昆士兰州（澳大利亚）由护理人员救治的儿科（>4 天-18 岁）OHCA 患者。描述患者和发病特征。调查与到达医院时自主循环恢复（ROSC）相关的因素。
共纳入 1612 例儿科患者；611 例在护理人员到达前死亡，1001 例接受护理人员复苏尝试。约四分之一（26.8%）接受复苏尝试的患者在到达医院时实现了 ROSC。大多数发病（49.7%）是由医疗原因引起的。创伤引起的发病到达医院时 ROSC 的发生率最低（9.6%），而药物过量引起的发病 ROSC 的发生率最高（40%）。农村地区患者到达医院时 ROSC 的发生率低于都市区（20.7% vs. 32.5%，p<0.001）。所有 OHCA 患者的中位反应时间为 8 分钟。农村地区创伤的发病率明显高于都市区，而其他病因相似。年龄较大的儿科年龄组到达医院时 ROSC 的发生率高于婴儿，尤其是青少年早期（39.4% vs. 14.9%，p=0.001）。发病原因、年龄、旁观者见证、可除颤初始节律和地理位置因素是到达医院时 ROSC 的独立相关因素。
约四分之一的儿科院外 OHCA 患者在到达医院时实现了 ROSC。院前结局因患者人群而异，与不同的患者人口统计学变量相关。
