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.
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.
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.
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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Resuscitation
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Unchanged pediatric out-of-hospital cardiac arrest incidence and survival rates with regional variation in North America.Resuscitation. 2016; 107: 121-128
- Long-term evolution after in-hospital cardiac arrest in children: prospective multicenter multinational study.Resuscitation. 2015; 96: 126-134
- American heart association council on epidemiology and prevention statistics committee and stroke statistics subcommittee. Heart disease and stroke statistics-2022 update: a report from the American Heart Association.Circulation. 2022; 145: e153-e639
- Neurobehavioral outcomes in children after out-of-hospital cardiac arrest.Pediatrics. 2016; 137: e20153412
- Longitudinal two years evaluation of neuropsychological outcome in children after out of hospital cardiac arrest.Resuscitation. 2021; 167: 29-37
- Long-term outcome of paediatric cardiorespiratory arrest in Spain.Resuscitation. 2005; 64: 79-85
- Cardiac arrest in children: long-term health status and health-related quality of life.Pediatric Crit Care Med. 2015; 16: 693-702
- Assessing the outcome of pediatric intensive care.J Pediatr. 1992; 121: 68-74
- Disability after severe head injury: observations on the use of the Glasgow Outcome Scale.J Neurol Neurosurg Psychiatry. 1981; 44: 285-293
- Validity of a pediatric version of the Glasgow Outcome Scale-Extended.J Neurotrauma. 2012; 29: 1126-1139
- Functional Status Scale: new pediatric outcome measure.Pediatrics. 2009; 124: e18-e28
- The PedsQL™: measurement model for the pediatric quality of life inventory.Med Care. 1999; : 126-139
- The PedsQL™ 4.0 generic core scales young adult version: feasibility, reliability and validity in a university student population.J Health Psychol. 2009; 14: 611-622
- The PedsQL™ family impact module: preliminary reliability and validity.Health Qual Life Out. 2004; 2: 1-6
- Vineland: adaptive behavior scales.American Guidance Service. 1984:; 346352
- BRIEF-2: Behavior rating inventory of executive function. Psychological Assessment.Resources. 2015;
- Behavior assessment system for children–Third Edition (BASC-3).Pearson. 2015;
- Health care utilization and needs after pediatric traumatic brain injury.Pediatrics. 2006; 117: e663-e674
- Functional outcome trajectories after out-of-hospital pediatric cardiac arrest.Crit Care Med. 2016; 44: e1165
- Long-term function after pediatric critical illness: results from the survivor outcomes study.Pediatr Crit Care Med. 2017; 18: e122-e130
- P-COSCA (Pediatric Core Outcome Set for Cardiac Arrest) in children: an advisory statement from the international liaison committee on resuscitation.Circulation. 2020; 142: e246-e261
- PICU follow-up clinic: patient and family outcomes 2 months after discharge.Pediatr Crit Care Med. 2021; 22: 935-943
- Persistence matters! Hurdles and high points of PICU follow-up clinic.Pediatr Crit Care Med. 2022; 23: e397-e399
- The value of screening parents for their risk of developing psychological symptoms after PICU: a feasibility study evaluating a pediatric intensive care follow-up clinic.Pediatr Crit Care Med. 2015; 16: 808-813
Published online: March 16, 2023
Accepted: March 9, 2023
Received in revised form: February 13, 2023
Received: December 23, 2022
Publication stageIn Press Journal Pre-Proof
© 2023 Published by Elsevier B.V.