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Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan.

Nagata T, Abe T, Noda E, Hasegawa M, Hashizume M, Hagihara A - BMJ Open (2014)

Bottom Line: Signal detection analysis using 17 variables was applied to identify factors associated with OHCA outcomes; the primary endpoint was cerebral performance category (CPC) 1 or 2.Rates of CPC 1 or 2 in the validation study did not differ among any subgroup.For children who have OHCA from non-cardiac origin, bystander rescue breathing is mandatory to achieve CPC 1 or 2.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medical Sciences, Department of Advanced Medical Initiatives, Kyushu University, Fukuoka, Japan.

ABSTRACT

Objectives: To better understand and predict clinical outcomes of paediatric out-of-hospital cardiac arrest (OHCA).

Design: A population-based, observational study.

Setting: The National Japan Utstein Registry.

Participants: 2900 children aged 5-17 years who experienced OHCA and received resuscitation by emergency responders. Signal detection analysis using 17 variables was applied to identify factors associated with OHCA outcomes; the primary endpoint was cerebral performance category (CPC) 1 or 2. A validation study was conducted to verify the model.

Results: OHCA was identified as cardiac origin in 706 participants and non-cardiac origin in 2194 participants. Rates of CPC 1 or 2 for cardiac and non-cardiac causes were 20% and 6.4%, respectively. Cardiac origin arrest was categorised following signal detection into six subgroups defined by public automated external defibrillator use, defibrillation by emergency medical service, age, initial ECG rhythm and eye-witness to arrest; the ranges of CPC 1 or 2 in the six subgroups were between 87.5% and 0.7%. Non-cardiac origin arrest was categorised into four subgroups. Bystander rescue breathing was the most significant factor contributing to outcome; additionally, two other factors-eye-witness to arrest and age-were also significant. CPC 1 or 2 rates ranged between 38.5% and 4% across the four subgroups. Rates of CPC 1 or 2 in the validation study did not differ among any subgroup.

Conclusions: For children who have OHCA from non-cardiac origin, bystander rescue breathing is mandatory to achieve CPC 1 or 2.

No MeSH data available.


Related in: MedlinePlus

Results of signal detection analysis related to cerebral performance category 1 or 2 among 2007–2010 patients with out-of-hospital cardiac arrest aged 5–17 years: non-cardiac origin (patients were randomly split into two halves. One half was used for this analysis and the other half was used for validation).
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BMJOPEN2013003481F3: Results of signal detection analysis related to cerebral performance category 1 or 2 among 2007–2010 patients with out-of-hospital cardiac arrest aged 5–17 years: non-cardiac origin (patients were randomly split into two halves. One half was used for this analysis and the other half was used for validation).

Mentions: The percentage of cases of non-cardiac OHCA with CPC 1 or 2 scores was 6.1% in the prediction sample (table 2). SDA revealed four subgroups, as numbered in figure 3, with percentages of CPC 1 or 2 ranging from 38.5% to 4%. Subgroups 1 and 3 were characterised by receiving bystander rescue breathing and eye-witness. These subgroups were distinguished by age of case. If cases were aged between 5 and 12 years (subgroup 1), CPC 1 or 2 percentage was 38.5%; if cases were aged between 13 and 17 years (subgroup 3), CPC 1 or 2 percentage was 8%. Subgroup 2 included cases in which there were no eye-witness or bystander rescue breathing; CPC 1 or 2 was scored in only 9.3% of cases. Subgroup 4 was also characterised as no bystander rescue breathing and CPC 1 or 2 was scored in 4% of cases.


Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan.

Nagata T, Abe T, Noda E, Hasegawa M, Hashizume M, Hagihara A - BMJ Open (2014)

Results of signal detection analysis related to cerebral performance category 1 or 2 among 2007–2010 patients with out-of-hospital cardiac arrest aged 5–17 years: non-cardiac origin (patients were randomly split into two halves. One half was used for this analysis and the other half was used for validation).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927934&req=5

BMJOPEN2013003481F3: Results of signal detection analysis related to cerebral performance category 1 or 2 among 2007–2010 patients with out-of-hospital cardiac arrest aged 5–17 years: non-cardiac origin (patients were randomly split into two halves. One half was used for this analysis and the other half was used for validation).
Mentions: The percentage of cases of non-cardiac OHCA with CPC 1 or 2 scores was 6.1% in the prediction sample (table 2). SDA revealed four subgroups, as numbered in figure 3, with percentages of CPC 1 or 2 ranging from 38.5% to 4%. Subgroups 1 and 3 were characterised by receiving bystander rescue breathing and eye-witness. These subgroups were distinguished by age of case. If cases were aged between 5 and 12 years (subgroup 1), CPC 1 or 2 percentage was 38.5%; if cases were aged between 13 and 17 years (subgroup 3), CPC 1 or 2 percentage was 8%. Subgroup 2 included cases in which there were no eye-witness or bystander rescue breathing; CPC 1 or 2 was scored in only 9.3% of cases. Subgroup 4 was also characterised as no bystander rescue breathing and CPC 1 or 2 was scored in 4% of cases.

Bottom Line: Signal detection analysis using 17 variables was applied to identify factors associated with OHCA outcomes; the primary endpoint was cerebral performance category (CPC) 1 or 2.Rates of CPC 1 or 2 in the validation study did not differ among any subgroup.For children who have OHCA from non-cardiac origin, bystander rescue breathing is mandatory to achieve CPC 1 or 2.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medical Sciences, Department of Advanced Medical Initiatives, Kyushu University, Fukuoka, Japan.

ABSTRACT

Objectives: To better understand and predict clinical outcomes of paediatric out-of-hospital cardiac arrest (OHCA).

Design: A population-based, observational study.

Setting: The National Japan Utstein Registry.

Participants: 2900 children aged 5-17 years who experienced OHCA and received resuscitation by emergency responders. Signal detection analysis using 17 variables was applied to identify factors associated with OHCA outcomes; the primary endpoint was cerebral performance category (CPC) 1 or 2. A validation study was conducted to verify the model.

Results: OHCA was identified as cardiac origin in 706 participants and non-cardiac origin in 2194 participants. Rates of CPC 1 or 2 for cardiac and non-cardiac causes were 20% and 6.4%, respectively. Cardiac origin arrest was categorised following signal detection into six subgroups defined by public automated external defibrillator use, defibrillation by emergency medical service, age, initial ECG rhythm and eye-witness to arrest; the ranges of CPC 1 or 2 in the six subgroups were between 87.5% and 0.7%. Non-cardiac origin arrest was categorised into four subgroups. Bystander rescue breathing was the most significant factor contributing to outcome; additionally, two other factors-eye-witness to arrest and age-were also significant. CPC 1 or 2 rates ranged between 38.5% and 4% across the four subgroups. Rates of CPC 1 or 2 in the validation study did not differ among any subgroup.

Conclusions: For children who have OHCA from non-cardiac origin, bystander rescue breathing is mandatory to achieve CPC 1 or 2.

No MeSH data available.


Related in: MedlinePlus