Aims: To investigate the characteristics of infant out-of-hospital cardiac arrest (OHCA) at home with and without identified causes and the factors associated with outcomes.
Methods: From the nation-wide database for 381,007 OHCA cases recorded during the period of 2017-2019, 1,584 (0.42%) with an age of 0 y were extracted. Extended database for 1,524 cases was constructed by the combining/reconciling with another database of EMS transportation including detailed information on OHCA locations and in-hospital diagnosis. After excluding 133 out-of-home cases, 429 cases in unusual circumstances, 43 neonatal (<28 weeks) cases and 17 cases without any resuscitation effort, 902 infant OHCA cases (396 and 506 cases, respectively with and without an identified cause) were analyzed. Univariate analyses for the comparison between the 2 groups with and without an identified cause) and multivariable logistic regression analysis for disclosure the factors associated with one-month survival were applied.
Results: Infant OHCA most frequently occurred in the winter (30.0%) and was most frequently detected in the morning (34.4%, 5:00 am to 9:00 am) and in living and private rooms (93.9%). The proportion of witnessed cases and incidence of prehospital defibrillation were very low (12.1% and 1.1%, respectively). Dispatcher-assisted CPR was conducted in 79.2% of cases and bystander cardiopulmonary resuscitation (BCPR) was performed in 66.6% of cases. Cases with an identified cause was associated with higher rates of physician in ambulance (9.1% vs 4.9%, P = 0.01) and one-month survival (9.9% vs 5.9%, P = 0.03). Witnessed cases (Adjusted OR;95% CI, 4.61;2.58-8.21) and prehospital defibrillation (24.2;1.96-298) were factors associated with one-month survival.
Conclusions: Infant OHCA is most frequently detected in the morning. The cause-identified cases were associated with a higher chance of survival. Education of family to enhance the preparedness and careful observation for life-threatening event is needed to increase the chance of survival.

Epidemiology and characteristics of infant out-of-hospital cardiac arrest and factors associated with outcome

Implementation of the Guidelines - How do we put the new ERC Guidelines into practice?

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