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Impact of puberty as threshold to differentiate outcome of out-of-hospital cardiac arrest care groups: a nationwide observational study in France
  1. Elodie Privat1,
  2. Valentine Baert1,2,
  3. Joséphine Escutnaire2,
  4. Cyrielle Dumont1,2,
  5. Morgan Recher1,2,
  6. Michael Genin1,2,
  7. Francis Leclerc1,
  8. Hervé Hubert1,2,
  9. Stephane Leteurtre1,2
  10. on behalf of the GR-RéAC
    1. 1Univ. Lille, CHU Lille, ULR 2694—METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille University Hospital Center, Lille, France
    2. 2French National Out-of-Hospital Cardiac Arrest Registry—Registre électronique des Arrêts Cardiaques (RéAC), Lille University Hospital Center, Lille, France
    1. Correspondence to Dr Stephane Leteurtre, Univ. Lille, CHU Lille, ULR 2694—METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille University Hospital Center, F-59000 Lille, Hauts-de-France, France; stephane.leteurtre{at}chru-lille.fr

    Abstract

    Background Since 2005, the international guidelines for out-of-hospital cardiac arrest (OHCA) use puberty to differentiate paediatric and adult care. This threshold is mainly relied on the more frequent respiratory aetiologies in children. Hitherto, to the best of our knowledge, no study has compared the characteristics and outcomes of non-pubescent children, adolescents and adult patients with OHCA. In this study, we intended to describe the characteristics, outcome and factors associated with survival of patients who experienced OHCA in the three groups: children, adolescents (pubescent<18 years) and adults (<65 years), to assess the pertinence of the guidelines.

    Methods Data from the French national cardiac arrest registry (2012–2017) were used in this nationwide observational study. Victims of OHCA who were <65 years old were included. The characteristics and outcomes of children and adolescents, and adolescents and adults were compared. Logistic regression was performed in each group to identify factors associated with survival at day 30.

    Results We included 934 children, 433 adolescents and 26 952 adults. Respiratory aetiology was more frequent and shockable rhythm less frequent in children compared with adolescents (25.5% vs 17.2%, p=0.025 and 2.4% vs 6.8%, p<0.001, respectively). However, these differences were not observed between adolescents and adults (17.2% vs 14.1%, p=0.266 and 6.8% vs 10%, p=0.055, respectively). Between children and adolescents, and adolescents and adults, there was no significant difference in survival at day 30 (8.6%vs 9.8% and 9.8% vs 8.5%, respectively). For all groups, shockable initial rhythm was a factor of survival.

    Conclusion Frequency of respiratory aetiologies and shockable rhythm were common in adolescents and adults and different between children and adolescents. These results indicate that puberty as a threshold in international guidelines seems to be relevant.

    • cardiac arrest
    • prehospital care
    • paediatrics
    • paediatric emergency medicine

    Data availability statement

    Data are available on reasonable request. Data are available on reasonable request using the website https://registreac.org/?page_id=2772

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    Data availability statement

    Data are available on reasonable request. Data are available on reasonable request using the website https://registreac.org/?page_id=2772

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    Footnotes

    • Handling editor Gene Yong-Kwang Ong

    • EP and VB contributed equally.

    • Collaborators GR-RéAC: Collaborators. Frederic Guillaumee, Agnes Ricard-Hibon, Patrick Fuster, Loic Huet, Aurelie Avondo, Florence Bages-Limoges, marion Dhers, Tobola Bellow, Jean-Claude Bartier, Olivier Peguet, Carine Kindle, Denis Gonzalez, Francois Revaux, Sylvie Besnier, Jean-Paul Lougnon, Benoit Jardel, Franck Monchard, Marc du Besset, David Pinero, Emmanuel Blottiaux, Nathalie Lefevre, Clement Buleon, Thibault Delemar, Paul Andregnette, Olivier Capel, Eryk Amiens, Aurelien Puchois, Sebastien Line, Stephane Gillet, Anne Dominique Curunet-Raoul, Jean-Charles Morel, Line Jacob, afandi Al Bassem, Anne-Sophie Genain-Soulier, Martine Moneron, Aurelie Louchet, Ghislain Richard, Jean-Luc Marquet, Olivier Watrelot, Claude Cheminat, Vincent Pegoraro, jean Francois Cicala, Fabienne Branche, Geoffroy Denoray, Julien Beharelle, geraldine Poincet, Paul-Henri Gendre, Guillaume Campagne, Patrice Serre, Meriem Hellal, Isabelle Kaliszczak, Cecile Ursat, Geoffrey Wyckaert, Guillaume Zamparini, Laurent Halbout, Philippe Pamart, Francois Dissait, Thierry Leraitre, Arnaud Malbranque, Marc Witte, Fabien Poher, Pierre Coffin, Alienor Senez, Sebastien Jonquet, Olivier Rebet, Sylvain Thiriez, Sebastien Dufraise, Jean Rouffineau, Salim Sebai, Steven Lagadec, David Harel, Max Beal, Claudine Remakel, Gerard Oriot, Frederic Orhon, Franck Dumas, Laure Jainsky, David Dall acqua, Davy Murgue, Andre Mazille, Thomas Monneret, Kevin Legendre, Patrick Poupart, Nicolas Briole, David Sapir, Gilles Leclerc, Caroline Line, Benoit Bertrand, Philippe Le, Jean yves Letarnec, Julien Segard, Gerald Sejourne, Christine Lespiaucq, Loic Amizet, Stephane Labed, Caroline Mesplede, Mounir Khiter, Marie laurence Fievet, Antoine Leroy, Sylvie Peyrat, Mathieu Doukhan, Marie Helene De facq, Trung Ta hung, Yannick Auffret, Alice Landel, Laurent Rebillard, Diego Abarrategui, Francois xavier Laborne, Alban Forel, Mauro Coletta, Rahman Paquirimoidine, Georges-Antoine Capitani, Lea Garcia, Charles noel Camard, Pascale Leurent, Gilles Majour, Roger Kadji, Jean-Christophe Robart, Daniel Bonnieux, Thomas Hullin, Idriss Arnaudet, Renaud Getti, Julien Raconnat, Arnaud Martinage, Sophie Narcisse, Estelle Legeard, Sonia Sadoune, Bonnet Clementine, Caroline Masson, Gaelle Arnaud, Anne sophie Chesneau, Thomas Pernot, Dominique Cailloce, Guillem Bouilleau, Muriel Vergne, Antoine Andre, Stevens Prineau, Jean-Philippe Kahn, Philippe Bargain, Helene Robert, Geraldine Butin, Sylvain Benenati, Marc Joly, Nathalie Roudiak, Stephanie Verissimo, Christophe Arnould, Isabelle Aune, Claire Gast, Van tricht Myriam, Clio Bohler, Hubert Courcoux, Christian Poirel, Mathieu Cornuault, Samia Bregigeon, Valery Collet, Bertrand Boulanger, Xavier Arrot, Isabelle Megy-Michoux, Jean marc Agostinucci, Antoine Daisey, Geraldine Gonzalez, Philippe Pes, Philippe Bertrand, Aurelie Begaudeau, Annelaure Paquet, Klein Thibaut, Christian Bar, Laurenne Paris, Sophie Boedec, Gilles Hernandez, Pierre-Julien Rogez, Elodie Dagoret, Edouard Dugat, Audrey Spriet, Michael Vial, Bruno Simonnet, Virginie Heydel, Lucile Bruere, Vincent Kuczer, Denis Casanova, Cecile Kernaleguen, Celine Longo, Julien Gay, abdi El, Stephane Saintonge, Florian Deuez, Vanessa Champenois, Sollweig Guinard, Patrick Barandiaran, Michel Maille, Cyrille Kamga, Joubioux Etienne, Guillaume Boulestein, Daniel Meyran, David Grua, Jean-Louis Rakotonirina, Xavier Lakermance, Lila Abdelli, Franck Vuillermoz, Michel Ferracci, Arnaud Lacroix, Marion Maurel, Joel Jenvrin, Melanie Laot, Eric Chiale, Corinne Wassong, Claire Desbuards, Sylvain Crindal, Serrano David, Raymond Henry, Francois Brau, Severine Boucard, Emelyne Cwicklinski, Eric Hollecker, Patricia Bernadet, Olivier David, Robin Tellier, Laurent Herkelmann, Michel Scherpereel, Anne Champenois, Hubert Delarue, Clement Babin, Mathieu Goichon, Frederick Langeron, tabchi Al Anas, Camille Dubois, Christine Goubet, Stephanie Deleu, Myriam Sussat, Marc Fournier, Linda Moine, Romain Tabary, Marie Druet, Melanie Goument, Jean-Sebastien Top, Laurent Cabanne, Virgine Lancon, Alexis Casalonga, Laure Pavageau, Sebastien Sabbat, Arsene Nguessan, David Gerault, Frederic Berthier, Claire Gradel, Claudie Audrain, Patrick Levy, Emmanuel Bernigaud, Pierre Gosset, Yoann Evain, Nicolas Hourdin, Fabrice Agbemebia, Michel Thicoipe, Celia Bouchel, Loic Lavaill, Camille Machet, Marie San Miguel, Beatrice Salaun, Eric Thibaud, Nicolas Desaveines, Nasri Fiani, Isabelle Vassor, Emilie Garay, Valentin Lefrancois, Frederique Robert, Serge Paula, Oriana Sanchez, Yony Benguigui, Julie Dumouchel, Jean-Christophe Auneau, Damien Robert, Herve Frances, Harold Auger, Guillaume Boon, Corinne Gonet-Dubois, Olivier Carle, Fabrice Alcouffe, Patrick Gatin, Cedric Touquet, Guillaume Ferrier, Solo Randriamalala, Lea Legay, Fabrice Girault, Melanie Monribot, Emilie Resplandy, Anne Payan, Vincent Gauclere, Emmanuelle Fritsch, Jacques Marchi, Philippe Fradin, Didier Roland-Billecart, Rudy Cohen, Marie-Sophie Viallard, Pierre-Alban Guenier, Cecile Plenier, Bastien Anette, Timothee Hiriart, Heloise Leroy, Catherine Pradeau, Olivier Durand, Laurence Steenbeke, Jean-Philippe Desclefs, Chantal Sanjuan, Frank Goes, Stephanie Polini, Carole Cornaglia, Perrine Sobocinski, Sophie Schvahn, Julien Tabarly, Xavier Paringaux, Coralie Gondret, Laurence Lepage, Eric Meinadier, Pascal Menot, Philippe Ciocca, Catherine Boussarie, Karina Heleniak, Gaele Aubert, Joelle Marchegay, Florence Gaillard, Laure Maugein, Carine Vanderstraeten, Thomas Guerin, Cyril Grandjon, Eric Sztil, Marie Naban, David Hamdan, Olivier Fillatre, Nicolas Duytsche, Dorine Pichon, Lucie Teyssier, Nathalie Lecadet, Laure Saada, Gregoire Versmee, Josephine Escutnaire, Thierry Babet, Cyril Bazzoli, Rejane Chomet, Olivier Guiot, Arnaud Le jan, Laurene Vasseur, Vilbois Emmanuel, Amandine Benard, Stephanie Bredel, Loik Connan, Catherine Delattre, Marie Soulat, Nicolas Roucaud, Vincent Kottmann, Guillaume Roze, Arnaud Devillard, Jerome Minost, Laure Hoffman, Amélie Saint, Sonia Ayllon-Milla, Gautier Ruellan, Thomas Dupuy, Jerome Frey, Imane Benaziz, Guillaume Jammes, Julien Mariage, Francois-Xavier Barthelemy, Marion Cousin, Philippe De boerio, Anne-Sophie Malaquin, Aurore Mahe, Martin Bataille, Christina Prouve, Pierre Rodriguez, Eric Tentillier, Thomas Quibel, Valentine Baert, Marion Menay, Phloy Rungsawad, Annabelle Rocheteau, Teddy Sturiale, Olivier Diez, Charlene Grard, Pierre Banwarth, Segolene Desoubeyran, Florence Naux, Nancy Gaillard, Carine Chassery, Emilie Gelin, Pascale Lamy, Jessica Lalande, Matthieu Yali, Julie Gouges, Fanny Moulinet, Julie Berger, Agnes Thivellier, Sandrra Bernard, Matthieu Gaget, Marike Bouret, Emmanuel Montassier, Matthias Garidou, Sami Abdelkhalek, Elodie Vidil, Valerie Schmitt, Rishad Vally, Barbara Villoing, Corinne Michenet, Laura Federici, Laure Corradi, Florian Robin, de mattos Gomes, Maxime Villard, Emmanuelle Fournier, Pascale Cavalli, Armelle Lafontaine, Antoine Duconge, Nathalie Goulois, Marie-Pierre Degos, Juliette Ferre, Roland 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    • Contributors EP and VB have contributed equally to the acquisition of data, substantial contributions to the analysis and interpretation of data for the work and drafted the manuscript and approved the final version and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. JE, CD and HH have substantial contributions to the acquisition of data, have substantial contributions to the analysis and interpretation of data for the work and revised it critically for important intellectual content and approved the final version and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MR, MG, FL and SL have substantial contributions to the analysis and interpretation of data for the work and revised it critically for important intellectual content and approved the final version and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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