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Background <p>Out-of-hospital cardiac arrest (OHCA) in children is rare and associated with poor outcomes. Data on aetiology-specific differences in short- and long-term survival are limited.</p> Methods <p>This multicentre, retrospective study included children (&lt; 18 years) with OHCA managed by a nationwide helicopter emergency medical service. Patient characteristics, OHCA-related variables, resuscitation interventions, and outcomes were collected. The primary objective was to compare sustained return of spontaneous circulation (ROSC), 30-day survival, and 1-year survival rates across different OHCA aetiologies.</p> Results <p>Among 9,018 patients with OHCA, 247 [2.7% (95% CI, 2.2–3.1%)] were children, of whom 200 were included. External or traumatic aetiologies accounted for 129 cases (64.5%). Non-traumatic OHCA occurred in 71 children (35.6%). Trauma was the most frequent aetiology [<i>n</i> = 78 (39.0%)], followed by drowning [<i>n</i> = 34 (17.0%)], non-cardiac non-traumatic causes [<i>n</i> = 27 (13.5%)], suspected cardiac causes [<i>n</i> = 27 (13.5%)], Sudden Infant Death Syndrome (SIDS) [<i>n</i> = 17 (8.5%)], and asphyxiation [<i>n</i> = 17 (8.5%)]. Sustained ROSC, 30-day survival, and 1-year survival differed significantly across aetiology groups (all <i>p</i> &lt; 0.001). Drowning was associated with the highest sustained ROSC (77.4%), 30-day (55.9%), and 1-year survival rates (50.0%), followed by non-cardiac non-traumatic causes (ROSC, 54.2%; 30-day survival, 38.5%; 1-year survival, 34.6%), and asphyxiation (ROSC, 57.1%; 30-day survival, 20.0%; 1-year survival, 20.0%). Outcomes were poorest in SIDS (ROSC, 20.0%; 30-day survival, 5.9%; 1-year survival, 5.9%). OHCA aetiology was independently associated with ROSC, 30-day, and 1-year survival rates in multivariable analyses.</p> Conclusions <p>Paediatric OHCA was rare and demonstrated marked heterogeneity in both aetiology and outcomes. Short- and long-term survival rates varied significantly across OHCA aetiologies.</p>

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Aetiology-dependent short- and long-term survival after paediatric out-of-hospital cardiac arrest: a multicentre, retrospective, cohort study

  • 期刊论文

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  • 发表日期：

    2026年6月24日

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  • Romana Erblich,
  • Matthias Noitz,
  • Marius Knöll,
  • Helmut Trimmel,
  • Wolfgang Voelckel,
  • Dominik Jenny,
  • Jens Meier,
  • Martin W. Dünser

摘要

Background

Out-of-hospital cardiac arrest (OHCA) in children is rare and associated with poor outcomes. Data on aetiology-specific differences in short- and long-term survival are limited.

Methods

This multicentre, retrospective study included children (< 18 years) with OHCA managed by a nationwide helicopter emergency medical service. Patient characteristics, OHCA-related variables, resuscitation interventions, and outcomes were collected. The primary objective was to compare sustained return of spontaneous circulation (ROSC), 30-day survival, and 1-year survival rates across different OHCA aetiologies.

Results

Among 9,018 patients with OHCA, 247 [2.7% (95% CI, 2.2–3.1%)] were children, of whom 200 were included. External or traumatic aetiologies accounted for 129 cases (64.5%). Non-traumatic OHCA occurred in 71 children (35.6%). Trauma was the most frequent aetiology [n = 78 (39.0%)], followed by drowning [n = 34 (17.0%)], non-cardiac non-traumatic causes [n = 27 (13.5%)], suspected cardiac causes [n = 27 (13.5%)], Sudden Infant Death Syndrome (SIDS) [n = 17 (8.5%)], and asphyxiation [n = 17 (8.5%)]. Sustained ROSC, 30-day survival, and 1-year survival differed significantly across aetiology groups (all p < 0.001). Drowning was associated with the highest sustained ROSC (77.4%), 30-day (55.9%), and 1-year survival rates (50.0%), followed by non-cardiac non-traumatic causes (ROSC, 54.2%; 30-day survival, 38.5%; 1-year survival, 34.6%), and asphyxiation (ROSC, 57.1%; 30-day survival, 20.0%; 1-year survival, 20.0%). Outcomes were poorest in SIDS (ROSC, 20.0%; 30-day survival, 5.9%; 1-year survival, 5.9%). OHCA aetiology was independently associated with ROSC, 30-day, and 1-year survival rates in multivariable analyses.

Conclusions

Paediatric OHCA was rare and demonstrated marked heterogeneity in both aetiology and outcomes. Short- and long-term survival rates varied significantly across OHCA aetiologies.