Affiliations 

  • 1 Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore, Singapore. Electronic address: tham.lai.peng@singhealth.com.sg
  • 2 Department of Emergency Medicine, Singapore General Hospital, Singapore
  • 3 Department of Primary Care and Public Health Sciences, King's College London, London, United Kingdom
  • 4 Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
  • 5 Medical Department, Singapore Civil Defence Force, Singapore, Singapore
  • 6 Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
  • 7 Department of Acute Medicine, Kindai University Faculty of Medicine, Osaka, Japan
  • 8 Emergency Department, Hospital Pulau Pinang, Penang, Malaysia
  • 9 Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
  • 10 Department of Emergency Medicine, Rajavithi Hospital, Bangkok, Thailand
  • 11 Department of Health and Medical Services, ED-Trauma Center, Rashid Hospital, Dubai, United Arab Emirates
  • 12 Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore; Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore
Resuscitation, 2018 04;125:111-117.
PMID: 29421664 DOI: 10.1016/j.resuscitation.2018.01.040

Abstract

BACKGROUND: The Pan Asian Resuscitation Outcomes Study (PAROS) is a retrospective study of out- of-hospital cardiac arrest(OHCA), collaborating with EMS agencies and academic centers in Japan, South Korea, Malaysia, Singapore, Taiwan, Thailand and UAE-Dubai. The objectives of this study is to describe the characteristics and outcomes, and to find factors associated with survival after paediatric OHCA.

METHODS: We studied all children less than 17 years of age with OHCA conveyed by EMS and non-EMS transports from January 2009 to December 2012. We did univariate and multivariate logistic regression analyses to assess the factors associated with survival-to-discharge outcomes.

RESULTS: A total of 974 children with OHCA were included. Bystander cardiopulmonary resuscitation rates ranged from 53.5% (Korea), 35.6% (Singapore) to 11.8% (UAE). Overall, 8.6% (range 0%-9.7%) of the children survived to discharge from hospital. Adolescents (13-17 years) had the highest survival rate of 13.8%. 3.7% of the children survived with good neurological outcomes of CPC 1 or 2. The independent pre-hospital factors associated with survival to discharge were witnessed arrest and initial shockable rhythm. In the sub-group analysis, pre-hospital advanced airway [odds ratio (OR) = 3.35, 95% confidence interval (CI) = 1.23-9.13] was positively associated with survival-to-discharge outcomes in children less than 13 years-old. Among adolescents, bystander CPR (OR = 2.74, 95%CI = 1.03-7.3) and initial shockable rhythm (OR = 20.51, 95%CI = 2.15-195.7) were positive factors.

CONCLUSION: The wide variation in the survival outcomes amongst the seven countries in our study may be due to the differences in the delivery of pre-hospital interventions and bystander CPR rates.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.