Long-term outcome of paediatric cardiorespiratory arrest in Spain☆
Introduction
Cardiorespiratory arrest (CRA) mortality remains very high both in adults [1], [2], [3], [4], [5] and children [6], [7], [8], [9], [10]. Besides the mortality, short- and long-term morbidity, and specifically, neuro-psychological status of patients after resuscitation, is a main concern. Some studies, restricted to adult patients, have assessed the long-term prognosis after CRA [2], [11], the neuro-psychological disabilities and the quality of life of survivors [12]. There are few studies including a significant number of subjects that have analysed the survival of children who experienced CRA [9], [10]. Until to the present some retrospective investigations have been done to assess the long-term neurological outcome of resuscitated children [13], [14], [15], [16], [17], [18], but only one prospective work that evaluated the long-term prognosis and sequelae of paediatric in-hospital CRA, in a single centre, is available [9].
We have carried out a prospective and multicentre study to know the current characteristics of paediatric CRA in Spain [19]. In this study, we report the long-term outcome of the survivors with special focus on the final cerebral and general performance status.
Section snippets
Patients and methods
An invitation to participate was sent to all the Paediatric Intensive Care Units (PICU), Paediatric Departments and out-of-hospital Emergency Medical Systems in Spain [20]. A protocol was drawn up in accordance with the Utstein style guidelines [21], [22]. Patients aged from 7 days to 18 years were eligible for the study if they had presented with respiratory arrest (RA), defined as the absence of respiration requiring assisted ventilation, or cardiac arrest (CA), defined as the absence of a
Results
From 1 April 1998 to 30 September 1999 we collected 311 CRA episodes, 73 respiratory arrest (23.5%) and 238 cardiac arrest (76.5%), that occurred in 283 children, with a mean age of 48 ± 54.4 months (range: 7 days to 17 years). Seventeen children (7.1%) suffered more than one CRA episode (range: 2–6).
Discussion
As far as we know, this is the first prospective multicentre study that analyses the long-term functional outcome of in-hospital and out-of-hospital CRA in children. Only one previously published study, done in a single centre, has analysed in-hospital paediatric CRA following the Utstein style, including long-term outcome aspects [9]. Survival of paediatric CRA has been dismal in most studies in the past; however, the crude long-term survival in this study has been 33%, a figure slightly
Acknowledgment
This study has been supported by a grant from the Fondo de Investigaciones Sanitarias 00/028.
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2015, ResuscitationCitation Excerpt :Finally, our study is limited by lack of long-term neurological follow-up and the use of only a global measure of neurological function, the PCPC, as a neurological outcome. However, previous studies suggest that neurological status at discharge is not substantially different from status at 6 months and 1 year after arrest, and the PCPC is the standard for Utstein reporting.12,21,22 Finally it is possible that the existing GWTG-R data elements fail to capture other, unmeasured confounders of outcomes, despite the use of suitable analytical techniques.
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A Spanish and Portuguese translated version of the Abstract and Keywords of this article appears at doi:10.1016/j.resuscitation.2004.07.010.
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Collaborators in the work: Jesús López-Herce, Cristina García, Angel Carrillo (Hospital Gregorio Marañón, Madrid), Pedro Domínguez (Hospital Valle de Hebrón, Barcelona), Maria A. García (Hospital del Niño Jesús, Madrid), Custodio Calvo (Hospital Materno Infantil, Málaga), Miguel A. Delgado (Hospital Infantil La Paz, Madrid), Antonio Rodríguez-Núñez (Hospital Clínico Universitario, Santiago), Jose A. Alonso (Hospital Virgen de la Salud, Toledo), Julio Melendo (Hospital Miguel Servet, Zaragoza), Corsino Rey (Hospital Central de Asturias, Oviedo), Teresa Hermana (Hospital de Cruces, Baracaldo), Josefina Cano (Hospital Virgen del Rocío, Sevilla), Francisco Romero (Servicio de Urgencias 061, Jaén), Servando Pantoja (Hospital Puerta del Mar, Cádiz), Carlos Lucena (061 de Almería), Pere Plaja (Hospital de Palamós, Gerona), Ana Concheiro (Hospital San Juan de Dios, Barcelona), Alvaro Díaz (Hospital de Tarrasa, Barcelona), Ricardo Martino (Hospital Príncipe de Asturias, Alcalá de Henares), Maria V. Esteban (Hospital Princesa de España, Jaén), Nieves de Lucas (SAMUR, Madrid), Esther Ocete (Hospital Clínico de Granada), Juan I. Muñoz (Hospital Reina Sofía, Córdoba), Maria A. Rodríguez (Hospital Comarcal da Barbanza, Coruña), Susana Simó (Servicio de Urgencias 061, Barcelona), Eduard Solé (Hospital Arnaú de Villanova, Lérida), Enrio Jiménez (Hospital del Mar, Barcelona), Rosario Alvarez (Hospital de Jarrio, Asturias), Víctor Canduela (Hospital de Laredo, Cantabria), Antonio Fernández (Hospital San Agustín, Linares), Amelia Sánchez-Galindo (Hospital Juan Canalejo, La Coruña), R. Closa (Hospital Juan XXIII, Barcelona), P. Villalobos (Hospital de Figueras, Gerona), Orenci Urraca (Hospital Nens, Barcelona), Federico Pérez (Hospital Josep Trueta, Gerona), Antonio Torres (Hospital San Juan de Dios, Úbeda), Miguel Labay (Hospital Obispo Polanco, Teruel), Ma Luisa Masiques (Hospital de Mollet, Barcelona), Fátima Aborto (Hospital Juan Ramón Jiménez, Huelva), Narcisa Palomino (Hospital Ciudad de Jaén, Jaén), Abadía, Hospital de la Selva, Gerona), Monserrat Miquel (Hospital San Celoni, Barcelona), Antonio Gómez Calzado (Hospital Virgen Macarena, Sevilla), Jose M Bellón and Maria La Calle (Gregorio Marañón Hospital, statistical data analysis).