Abstract
Background
Survival following pediatric out-of-hospital cardiac arrest (OHCA) has improved over
the past 2 decades but data on survivors’ long-term outcomes are limited. We aimed
to evaluate long-term outcomes in pediatric OHCA survivors more than one year after
cardiac arrest.
Methods
OHCA survivors <18 years old who received post-cardiac arrest care in the PICU at
a single center between 2008–2018 were included. Parents of patients <18 years and
patients ≥18 years at least one year after cardiac arrest completed a telephone interview.
We assessed neurologic outcome (Pediatric Cerebral Performance Category [PCPC]), activities
of daily living (Pediatric Glasgow Outcomes Scale-Extended, Functional Status Scale
(FSS)), HRQL (Pediatric Quality of Life Core and Family Impact Modules), and healthcare
utilization. Unfavorable neurologic outcome was defined as PCPC > 1 or worsening from
pre-arrest baseline to discharge.
Findings
Forty four patients were evaluable. Follow-up occurred at a median of 5.6 years [IQR
4.4, 8.9] post-arrest. Median age at arrest was 5.3 [1.3,12.6] years; median CPR duration
was 5 [1.5, 7] minutes. Survivors with unfavorable outcome at discharge had worse
FSS Sensory and Motor scores and higher rates of rehabilitation service utilization.
Parents of survivors with unfavorable outcome reported greater disruption to family
functioning. Healthcare utilization and educational support requirements were common
among all survivors.
Conclusions
Survivors of pediatric OHCA with unfavorable outcome at discharge have more impaired
function multiple years post-arrest. Survivors with favorable outcome may experience
impairments and significant healthcare needs not fully captured by the PCPC at hospital
discharge.
Keywords
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Article info
Publication history
Published online: March 16, 2023
Accepted:
March 9,
2023
Received in revised form:
February 13,
2023
Received:
December 23,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier B.V.
