Zhao Xiangkai, Zheng Wen, Ma Yu, Hou Yaping, Zhu Yimin, Zheng Jiaqi, Wang Quan, Pan Chang, Zhang Jianbo, Wang Chunyi, Bian Yuan, Liu Rugang, Cheng Kai, Ma Jingjing, Ong Marcus Eng Hock, Xu Feng, Chen Yuguo
Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan, China.
Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China.
Crit Care Med. 2024 Dec 1;52(12):e604-e615. doi: 10.1097/CCM.0000000000006436. Epub 2024 Oct 7.
To comprehensively describe the incidence, process of care, outcomes, and variation among different age groups of pediatric out-of-hospital cardiac arrest (OHCA) in China.
The Baseline Investigation of Out-of-Hospital Cardiac Arrest (BASIC-OHCA) is a prospective, multicenter, population-based registry of emergency medical services (EMS)-assessed OHCA in China.
A total of 25 monitoring sites of all seven geographical regions were included, covering a pediatric population (age ≤ 19) of around 22.3 million in China.
Pediatric patients enrolled in BASIC-OHCA from August 2019 to December 2020 were included.
None.
A total of 1493 pediatric patients with EMS-assessed OHCA were enrolled, and resuscitation was attempted in 651 cases (43.6%). The crude incidence of EMS-assessed and EMS-treated OHCA was 5.5 (95% CI, 5.2-5.9) and 2.4 (95% CI, 2.2-2.6) per 100,000 pediatric population. Among 651 EMS-treated OHCA cases, 434 patients (66.7%) were male, and 353 (54.2%) had nonmedical causes (trauma, asphyxia, and drowning being the most common). There were 396 patients (60.8%) who collapsed at home, and the proportion of cases that occurred in public places such as streets and schools increased with age. There were 26 patients (4.0%) who had an initial shockable rhythm. For 626 non-EMS-witnessed patients, 152 patients (24.3%) received bystander cardiopulmonary resuscitation (CPR), 68 (10.9%) received dispatcher-assisted CPR, and 3 (0.5%) had automated external defibrillator applied. The survival to discharge or 30 days was 3.5% (23/651), and the favorable neurologic prognosis was 3.1% (20/651), with no differences among age groups.
This study provides the first national exploration of pediatric OHCA in China. The high proportion of nonmedical causes underscores the importance of preventing accidents in children. Gaps in the chain of survival and patient outcomes provide a focus for improving the treatment of pediatric OHCA in China and other developing countries.
全面描述中国儿童院外心脏骤停（OHCA）在不同年龄组中的发病率、治疗过程、结局及差异。
院外心脏骤停基线调查（BASIC - OHCA）是一项在中国进行的前瞻性、多中心、基于人群的急诊医疗服务（EMS）评估的OHCA登记研究。
纳入了所有七个地理区域的共25个监测点，覆盖中国约2230万儿科人群（年龄≤19岁）。
纳入2019年8月至2020年12月在BASIC - OHCA登记的儿科患者。
无。
共纳入1493例经EMS评估的儿童OHCA患者，其中651例（43.6%）尝试进行了复苏。经EMS评估且接受治疗的OHCA的粗发病率为每10万儿科人群5.5例（95%CI，5.2 - 5.9），接受治疗的为每10万儿科人群2.4例（95%CI，2.2 - 2.6）。在651例接受EMS治疗的OHCA病例中，434例（66.7%）为男性，353例（54.2%）有非医疗原因（创伤、窒息和溺水最为常见）。396例（60.8%）患者在家中发生心脏骤停，在街道和学校等公共场所发生的病例比例随年龄增加。有26例（4.0%）患者初始心律为可电击心律。对于626例非EMS目击患者，152例（24.3%）接受了旁观者心肺复苏（CPR），68例（10.9%）接受了调度员辅助CPR，3例（0.5%）使用了自动体外除颤器。出院或30天生存率为3.5%（23/651），良好神经功能预后为3.1%（20/651），各年龄组之间无差异。
本研究首次对中国儿童OHCA进行了全国性探索。非医疗原因比例高凸显了预防儿童意外事故的重要性。生存链和患者结局方面的差距为改善中国及其他发展中国家儿童OHCA的治疗提供了重点。
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