The epidemiology of cardiac arrest in children and young adults

Abstract Aim: To describe the epidemiology of children and young adults suffering from out-of-hospital cardiac arrest. Patients: All patients suffering from out-of-hospital cardiac arrest in whom, resuscitation efforts were attempted in the community of Goteborg between 1980 and 2000. Methods: Between 31 October 1980 and 31 October 2000, all consecutive cases of cardiac arrest in which the emergency medical service (EMS) system responded and attempted resuscitation were reported and followed-up to discharge from hospital. Results: Among 5505 cardiac arrests information on age was available in 5290 cases (96%). Of these 5290 cases 98 (2%) were children (age 0–17 years), 197 (4%) were young adults (age 18–35 years) and the remaining 4995 (94%) were adults (age >35 years). Children and young adults differed from adults by suffering from a witnessed arrest less frequently, being found by the ambulance crew in ventricular fibrillation/tachycardia less frequently and being judged as having an underlying cardiac aetiology less frequently. Of the children only 5% were discharged from hospital alive compared with 8% for young adults and 9% for adults. Among survivors the cerebral performance categories (CPC) score at discharge tended to differ with 38% of young adults registering a CPC score of 1 (no neurological deficit) compared with 52% among adults. Conclusion: Children and young adults suffering from out-of-hospital cardiac arrest differed from adults in terms of aetiology and observed initial arrhythmia. Children had a particularly bad outcome whereas young adults had a similar outcome as adults.