J Korean Med Sci.  2015 Sep;30(9):1354-1360. 10.3346/jkms.2015.30.9.1354.

Epidemiological and Survival Trends of Pediatric Cardiac Arrests in Emergency Departments in Korea: A Cross-sectional, Nationwide Report

• Ahn JY
• Lee MJ
• Kim H
• Yoon HD
• Jang HY

• KMID: 2344164
• DOI: http://doi.org/10.3346/jkms.2015.30.9.1354

Abstract

Cardiac arrest (CA) in children is associated with high mortality rates. In Korea, cohort studies regarding the outcomes of pediatric CAs are lacking, especially in emergency departments (EDs) or in-hospital settings. This study was conducted to examine the trends in epidemiology and survival outcomes in children with resuscitation-attempted CAs using data from a cross-sectional, national, ED-based clinical registry. We extracted cases in which cardiopulmonary resuscitation and/or manual defibrillation were performed according to treatment codes using the National Emergency Department Information System (NEDIS) from 2008 to 2012. The total number of ED visits registered in the NEDIS during the 5-yr evaluation period was 20,424,530; among these, there were 2,970 resuscitation-attempted CAs in children. The annual rates of pediatric CAs per 1,000 ED visits showed an upward trend from 2.81 in 2009 to 3.62 in 2012 (P for trend = 0.045). The median number of estimated pediatric CAs at each ED was 7.8 (25th to 75th percentile, 4 to 13) per year. The overall rates for admission survival and discharge survival were 35.2% and 12.8%, respectively. The survival outcome of adults increased substantially over the past 5 yr (11.8% in 2008, 11.7% in 2010, and 13.6% in 2012; P for trend = 0.001); however, the results for children did not improve (13.6% in 2008, 11.4% in 2010, and 13.7% in 2012; P for trend = 0.870). Conclusively, we found that the overall incidence of pediatric CAs in EDs increased substantially over the past 5 yr, but without significantly higher survival outcomes.

Keyword

Pediatrics; Heart Arrest; Resuscitation; Outcome; Emergency Service, Hospital

MeSH Terms

Adolescent
Cardiopulmonary Resuscitation/*mortality
Child
Child, Preschool
Cross-Sectional Studies
Emergency Service, Hospital/*statistics & numerical data
Female
Heart Arrest/*epidemiology/*prevention & control
*Hospital Mortality
Humans
Incidence
Infant
Male
*Registries
Republic of Korea/epidemiology
Risk Factors
Survival Rate
Treatment Outcome
Young Adult

Figure

• 

  Fig. 1 Patient flow according to the National Emergency Department Information System database determined based on resuscitated pediatric cardiac arrests in the emergency department. ER, emergency room; NEDIS, National Emergency Department Information System; CA, cardiac arrest; VT, ventricular tachycardia; VF, ventricular fibrillation.

• 

  Fig. 2 Circadian survival rhythm of pediatric cardiac arrests (CAs) in the emergency department (ED).

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  Fig. 3 Trend plots of survival discharge in children (A) and adults (B) by calendar year. During the past 5 yr, the proportion of children survivors (overall, cardiac, and trauma group) did not improve (all P for trend > 0.05). However, the proportion of adult survivors (overall and non-traumatic group) increased over time (P for trend < 0.05).

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