Abstract
Aim
In this study, we sought to quantitatively describe the survival outcomes, incidence
rates, and predictors of survival after paediatric traumatic out-of-hospital cardiac
arrest (OHCA).
Methods
We systematically searched MEDLINE, EMBASE, EMCARE, and CINAHL to identify observational
or interventional studies reporting relevant data for paediatric traumatic OHCA. The
Joanna Briggs Institute critical appraisal tool for prognostic studies was used to
assess study quality. We analysed the survival outcomes and pooled incidence rates
per 100,000 person-years using random-effect models.
Results
Nineteen articles met the eligibility criteria involving 705 Emergency Medical Service
(EMS)-attended and 973 EMS-treated traumatic paediatric OHCAs across an estimated
serviceable population of 15.2 million. Four studies were conducted in the Asia-pacific
region, seven in Europe, and eight in North America. Nine studies were assessed as
low quality. Overall pooled survival to hospital discharge or 30-day survival for
the EMS-treated cases was 1.2% (n = 6 studies; 95% confidence interval (CI): 0.1%,
3.1%; I2 = 26.1%). The pooled rate of return of spontaneous circulation in four studies was
22.1% (95% CI: 18.4%, 26.1%; I2 = 0.0%), and the pooled rate of event survival was 18.8% (n = 3 studies; 95% CI:
15.2%, 22.7%; I2 = 0.0%). The pooled incidence of EMS-treated paediatric traumatic OHCA was 1.6 cases
per 100,000 person-years (n = 10 studies; 95% CI: 1.1, 2.2; I2 = 98.1%). No study reported on the impact of epidemiological or clinical factors
on survival.
Conclusion
Survival outcomes of paediatric traumatic OHCA are poor and existing studies report
varying incidence rates. The absence of large prospective and international registry
data hinders the development of novel strategies to improve survival rates.
Keywords
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Article info
Publication history
Published online: February 15, 2020
Accepted:
January 29,
2020
Received in revised form:
January 19,
2020
Received:
October 18,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
