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Epidemiological and Survival Trends of Pediatric Cardiac Arrests in Emergency Departments in Korea: A Cross-sectional,Nationwide Report
Authors:Jae Yun Ahn  Mi Jin Lee  Hyun Kim  Han Deok Yoon  Hye Young Jang
Affiliation:1Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.;2Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.;3National Emergency Medical Center, Seoul, Korea.;4Department of Emergency Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.;5The Korean Association of Cardiopulmonary Resuscitation, Seoul, Korea.
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.

Graphical Abstract

Keywords:Pediatrics   Heart Arrest   Resuscitation   Outcome   Emergency Service   Hospital
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