by Stephan
Katzenschlager, Inga K. Kelpanides, Patrick Ristau, Matthias Huck, Stephan
Seewald, Sebastian Brenner, Florian Hoffmann, Jan Wnent, Jo Kramer-Johansen,
Ingvild B. M. Tjelmeland, Markus A. Weigand, Jan-Thorsten Gräsner and Erik Popp
Critical Care volume 27,
Article number: 349 (2023)
Aim
This work provides an epidemiological overview of
out-of-hospital cardiac arrest (OHCA) in children in Germany between 2007 and
2021. We wanted to identify modifiable factors associated with survival.
Methods
Data from the German Resuscitation Registry (GRR) were used,
and we included patients registered between 1st January 2007 and 31st December
2021. We included children aged between > 7 days and 17 years,
where cardiopulmonary resuscitation (CPR) was started, and treatment was
continued by emergency medical services (EMS). Incidences and descriptive
analyses are presented for the overall cohort and each age group. Multivariate
binary logistic regression was performed on the whole cohort to determine the
influence of (1) CPR with/without ventilation started by bystander, (2) OHCA
witnessed status and (3) night-time on the outcome hospital admission with
return of spontaneous circulation (ROSC).
Results
OHCA in children aged < 1 year had the highest
incidence of the same age group, with 23.42 per 100 000. Overall, hypoxia
was the leading presumed cause of OHCA, whereas trauma and drowning accounted
for a high proportion in children aged > 1 year. Bystander-witnessed
OHCA and bystander CPR rate were highest in children aged 1–4 years, with
43.9% and 62.3%, respectively. In reference to EMS-started CPR, bystander CPR
with ventilation were associated with an increased odds ratio for ROSC at
hospital admission after adjusting for age, sex, year of OHCA and location of
OHCA.
Conclusion
This study provides an epidemiological overview of OHCA in
children in Germany and identifies bystander CPR with ventilation as one
primary factor for survival.
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