RT Journal Article
SR Electronic
T1 Impact of puberty as threshold to differentiate outcome of out-of-hospital cardiac arrest care groups: a nationwide observational study in France
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 363
OP 369
DO 10.1136/emermed-2020-210447
VO 39
IS 5
A1 Privat, Elodie
A1 Baert, Valentine
A1 Escutnaire, Joséphine
A1 Dumont, Cyrielle
A1 Recher, Morgan
A1 Genin, Michael
A1 Leclerc, Francis
A1 Hubert, Hervé
A1 Leteurtre, Stephane
A1 ,
YR 2022
UL http://emj.bmj.com/content/39/5/363.abstract
AB 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.Data are available on reasonable request. Data are available on reasonable request using the website https://registreac.org/?page_id=2772