J Korean Med Sci.  2022 Nov;37(44):e317. 10.3346/jkms.2022.37.e317.

National Surveillance of Pediatric Outof-Hospital Cardiac Arrest in Korea: The 10-Year Trend From 2009 to 2018

• Kim M
• Yu J
• Chang H
• Heo S
• Lee SU
• Hwang SY
• Yoon H
• Cha WC
• Shin TG
• Kim T

• KMID: 2535181
• DOI: http://doi.org/10.3346/jkms.2022.37.e317

Abstract

Background
This study reports trends in pediatric out-of-hospital cardiac arrest (OHCA) and factors affecting clinical outcomes by age group.
Methods
We identified 4,561 OHCA patients younger than 18 years between January 2009 and December 2018 in the Korean OHCA Registry. The patients were divided into four groups: group 1 (1 year or younger), group 2 (1 to 5 years), group 3 (6 to 12 years), and group 4 (13 to 17 years). The primary outcome was survival to hospital discharge, and the secondary outcomes were return of spontaneous circulation (ROSC) at the emergency department (ED) and good neurological status at discharge. Multivariate logistic analyses were performed.
Results
The incidence rate of pediatric OHCA in group 1 increased from 45.57 to 60.89 per 100,000 person-years, while that of the overall population decreased over the 10 years. The rates of ROSC at the ED, survival to hospital discharge, and good neurologic outcome were highest in group 4 (37.9%, 9.7%, 4.9%, respectively) and lowest in group 1 (28.3%, 7.1%, 3.2%). The positive factors for survival to discharge were event location of a public/commercial building or place of recreation, type of first responder, prehospital delivery of automated external defibrillator shock, initial shockable rhythm at the ED. The factors affecting survival outcomes differed by age group.
Conclusion
This study reports comprehensive trends in pediatric OHCA in the Republic of Korea. Our findings imply that preventive methods for the targeted population should be customized by age group.

Keyword

Out-of-Hospital Cardiac Arrest; Pediatrics; Cardiopulmonary Resuscitation; Population Surveillance; Age Groups

Figure

• 

  Fig. 1 Population and IR of cardiac arrest in (A) group 1, (B) group 2, (C) group 3 and (D) group 4 from 2009 to 2018. The bar graph (blue) represents the population of each age group, and the line graph (red) shows the incidence rate of cardiac arrest.IR = incidence rate.

• 

  Fig. 2 Study population and flowchart.OHCA = out-of-hospital cardiac arrest, CPR = cardiopulmonary resuscitation, ED = emergency department.

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  Fig. 3 Annual change in the proportion of injury as the cause of pediatric out-of-hospital cardiac arrest. The line graph (blue, orange, grey, yellow) represents the annual change in the proportion of injury among the causes of cardiac arrest of groups 1, 2, 3 and 4, respectively.

• 

  Fig. 4 Trends in ROSC, survival to discharge, and good neurologic outcomes in (A) overall age groups, (B) group 1, (C) group 2, (D) group 3 and (E) group 4 from 2009 to 2018. The line graph (blue) shows the ROSC of each age group. The line graph (orange) shows the survival to discharge of each age group. The line graph (gray) shows the good neurologic outcome of each age group.ROSC = return of spontaneous circulation.

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