Skip to main content

Epidemiology and outcome analysis of children with traumatic out-of-hospital cardiac arrest compared to nontraumatic cardiac arrest

Pediatric Surgery International volume 29, pages 471–477 (2013)Cite this article

Abstract

Purpose

This study aimed to determine predictive factors for sustained return of spontaneous circulation (ROSC) in pediatric patients with traumatic out-of-hospital cardiac arrest (OHCA) and compared to those with nontraumatic OHCA.

Methods

This was a retrospective prognostic study of children with OHCA presenting to the emergency department (ED) was conducted from 2005 to 2010. Related clinical factors that influenced sustained ROSC in traumatic OHCA patients were identified and compared to nontraumatic cases. Significant parameters in predicting sustained ROSC in traumatic OHCA children were also determined using multivariate logistic regression analysis, and etiologies of the ICU admissions were analyzed in patients with sustained ROSC.

Results

Among 2,978 critically ill children admitted to the ED, 150 were pediatric OHCA patients, including 76 traumatic cases and 74 nontraumatic cases. Of children with OHCA, initial sustained ROSC was achieved in 51 cases (34.0 %), including 31 traumatic cases and 20 of nontraumatic cases. Head and neck injuries were the majority of traumatic cases in the traumatic OHCA children, followed by abdominal injuries and chest injuries. However, abdominal injuries accounted for the highest rate to gain sustained ROSC, while chest injuries had the lowest rate for successful sustained ROSC. Significant factors associated with sustained ROSC in traumatic OHCA included initial cardiac rhythm (P < 0.05), the period from scene to hospital (P < 0.05), and the duration of in-hospital cardiopulmonary resuscitation (CPR) (P < 0.05).

Conclusions

Significant factors related to sustained ROSC have been identified as initial cardiac rhythm, duration of in-hospital CPR, and the period from scene to hospital. Head and neck injuries were the majority of traumatic cases and the prevention in head and neck trauma may play an important part in public health aspects.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. American College of Emergency Physicians (1990) The role of the emergency physician in the care of children. Ann Emerg Med 19:435–436

    Article  Google Scholar 

  2. Tibballs J, Kinney S (2009) Reduction of hospital mortality and of preventable cardiac arrest and death on introduction of a pediatric medical emergency team. Pediatr Crit Care Med 10:306–312

    PubMed  Article  Google Scholar 

  3. Yang WC, Lin YR, Zhao LL, Wu YK, Chang YJ, Chen CY, Wu KH, Wu HP (2013) Epidemiology of pediatric critically-ill patients presenting to the pediatric emergency department. Klin Padiatr 225:18–23

    PubMed  Article  Google Scholar 

  4. Lin YR, Wu HP, Huang CY, Chang YJ, Lin CY, Chou CC (2007) Significant factors in predicting sustained ROSC in paediatric patients with traumatic out-of-hospital cardiac arrest admitted to the emergency department. Resuscitation 74:83–89

    PubMed  Article  Google Scholar 

  5. Moriwaki Y, Sugiyama M, Yamamoto T, Tahara Y, Toyoda H, Kosuge T, Harunari N, Iwashita M, Arata S, Suzuki N (2011) Outcomes from prehospital cardiac arrest in blunt trauma patients. World J Surg 35:34–42

    PubMed  Article  Google Scholar 

  6. Schindler MB, Bohn D, Cox PN, McCrindle BW, Jarvis A, Edmonds J, Gl Barker (1996) Outcome of out-of-hospital cardiac or respiratory arrest in children. N Engl J Med 335:1473–1479

    PubMed  Article  CAS  Google Scholar 

  7. Cunningham LM, Mattu A, O’Connor RE, Brady WJ (2012) Cardiopulmonary resuscitation for cardiac arrest: the importance of uninterrupted chest compressions in cardiac arrest resuscitation. Am J Emerg Med 30:1630–1638

    PubMed  Article  Google Scholar 

  8. Mooney DP, Gutierrez IM, Chen Q, Forbes PW, Zurakowski D (2013) Impact of trauma system development on pediatric injury care. Pediatr Surg Int 29:263–268

    PubMed  Article  Google Scholar 

  9. Dieckmann RA, Vardis R (1995) High-dose epinephrine in pediatric out-of hospital cardiopulmonary arrest. Pediatrics 95:901–913

    PubMed  CAS  Google Scholar 

  10. Herlitz J, Engdahl J, Svensson L, Young M, Angquist KA, Holmberg S (2005) Characteristics and outcome among children suffering from out of hospital cardiac arrest in Sweden. Resuscitation 64:37–40

    PubMed  Article  CAS  Google Scholar 

  11. Kenny D, Martin R (2011) Drowning and sudden cardiac death. Arch Dis Child 96:5–8

    PubMed  Article  CAS  Google Scholar 

  12. Deasy C, Bray JE, Smith K, Harriss LR, Bernard SA, Cameron P (2011) Out-of-hospital cardiac arrests in young adults in Melbourne Australia. Resuscitation 82:830–834

    PubMed  Article  CAS  Google Scholar 

  13. Deasy C, Bray JE, Smith K, Harriss LR, Bernard SA, Davidson PM, Cameron P (2012) Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne Australia. Resuscitation 83:58–62

    PubMed  Article  CAS  Google Scholar 

  14. Bardai A, Berdowski J, van der Werf C, Blom MT, Ceelen M, van Langen IM, Tijssen JG, Wilde AA, Koster RW, Tan HL (2011) Incidence, causes, and outcomes of out-of-hospital cardiac arrest in children. A comprehensive, prospective, population-based study in the Netherlands. J Am Coll Cardiol 3(57):1822–1828

    Article  Google Scholar 

  15. Li CJ, Kung CT, Liu BM, Chou CC, Chang CF, Wu TK, Liu TA, Lin TR (2010) Factors associated with sustained return of spontaneous circulation in children after out-of-hospital cardiac arrest of noncardiac origin. Am J Emerg Med 28:310–317

    PubMed  Article  Google Scholar 

  16. Atkins DL, Everson-Stewart S, Sears GK, Daya M, Osmond MH, Warden CR, Berg RA, Resuscitation Outcomes Consortium Investigators (2009) Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the resuscitation outcomes consortium epistry-cardiac arrest. Circulation 119:1484–1491

    PubMed  Article  Google Scholar 

  17. Atkins DL, Berger S (2012) Improving outcomes from out-of-hospital cardiac arrest in young children and adolescents. Pediatr Cardiol 33:474–483

    PubMed  Article  Google Scholar 

  18. Kleinman ME, Chameides L, Schexnayder SM, Samson RA, Hazinski MF, Atkins DL et al (2010) Part 14: pediatric advanced life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 122:S876–S908

    PubMed  Article  Google Scholar 

  19. Kleinman ME, Chameides L, Schexnayder SM, Samson RA, Hazinski MF, Atkins DL, Berg MD, de Caen AR, Fink EL, Freid EB, Hickey RW, Marino BS, Nadkarni VM, Proctor LT, Qureshi FA, Sartorelli K, Topjian A, van der Jagt EW, Zaritsky AL (2010) Part 13: pediatric basic life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 122:S862–S875

    Article  Google Scholar 

Download references

Conflict of interest

There is no conflict of interest related to this study.

Author information

Affiliations

  1. Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan, R.O.C

    Chun-Yu Chen & Wen-Chieh Yang

  2. Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan, R.O.C

    Yan-Ren Lin

  3. School of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C

    Yan-Ren Lin

  4. Department of Biological Science and Technology and Institute of Biochemical Engineering, National Chiao Tung University, Hsinchu, Taiwan, R.O.C

    Yan-Ren Lin

  5. Department of Pediatrics, Buddhist Tzu-Chi General Hospital, Taipei Branch, Taipei, R.O.C

    Lu-Lu Zhao

  6. Department of Surgery, Buddhist Tzu-Chi General Hospital, Taichung Branch, Taichung, Taiwan, R.O.C

    Yung-Kang Wu

  7. Laboratory of Epidemiology and Biostatistics, Changhua Christian Hospital, Changhua, Taiwan, R.O.C

    Yu-Jun Chang

  8. Department of Pediatrics, Children’s Hospital and School of Chinese Medicine, China Medical University Hospitals, Taichung, Taiwan, R.O.C

    Kang-Hsi Wu

  9. Department of Pediatrics, Buddhist Tzu-Chi General Hospital, Taichung Branch, No. 66, Section 1, Fongsing Road, Taichung, 42743, Taiwan, R.O.C

    Han-Ping Wu

  10. Department of Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan, R.O.C

    Han-Ping Wu

Authors
  1. Chun-Yu Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yan-Ren Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lu-Lu Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yung-Kang Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yu-Jun Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Wen-Chieh Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kang-Hsi Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Han-Ping Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Han-Ping Wu.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Chen, CY., Lin, YR., Zhao, LL. et al. Epidemiology and outcome analysis of children with traumatic out-of-hospital cardiac arrest compared to nontraumatic cardiac arrest. Pediatr Surg Int 29, 471–477 (2013). https://doi.org/10.1007/s00383-013-3302-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-013-3302-z

Keywords

  • Epidemiology
  • CPR
  • OHCA
  • Trauma
  • Children