Outcomes After Pediatric Out-of-Hospital Cardiopulmonary Interventions
| Autor: | Jennifer Y. Lo, Jason Clawson, Miles Christensen, Lloyd Y. Tani, Shaji C. Menon, Xiaoming Sheng |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Emergency Medical Services Pediatrics medicine.medical_specialty Time Factors Adolescent Psychological intervention 030204 cardiovascular system & hematology Cohort Studies 03 medical and health sciences 0302 clinical medicine Risk Factors Utah Emergency medical services medicine Humans 030212 general & internal medicine Child Survival rate business.industry Infant General Medicine Odds ratio EMS dispatch Cardiopulmonary Resuscitation Confidence interval Survival Rate Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Emergency Medicine Female Observational study business Out-of-Hospital Cardiac Arrest Cohort study |
| Zdroj: | Pediatric Emergency Care. 34:267-272 |
| ISSN: | 0749-5161 |
| Popis: | Objective The aim of the study was to evaluate outcomes after pediatric out-of-hospital cardiopulmonary interventions (CPIs) by emergency medical services (EMS). Methods Children (age, ≤18 years) who received CPI by EMS from 2001 to 2008 were identified from the Utah Department of Health. Cardiopulmonary intervention was defined as oxygenation, ventilation or CPR, and transport to a hospital by EMS. Univariate and multivariable regression analyses evaluated associations between potential predictors and outcomes (death and new neurologic dysfunction). Results A total of 464 patients (58% male) received EMS attention. For the 71% patients (327) who were alive on EMS arrival, 63% (205) received CPI without CPR. Of note, 6% (12) of these patients died after arrival to the hospital and new neurologic dysfunction was diagnosed in 6% (13). Among the 12 patients who died, 50% (6) were younger than 1 year.On multivariable regression analysis, factors associated with increased risk of death before and in-hospital are the following: age younger than 1 year (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.17-0.39), shorter EMS transport time (OR, 0.94; 95% CI, 0.89-0.99), and longer EMS dispatch time (OR, 1.23; 95% CI, 1.08-1.40). Factors associated with increased risk of new neurologic dysfunction are the following: lack of pulse (OR, 0.14; 95% CI, 0.04-0.53), requiring CPR (OR, 6.15; 95% CI, 1.48-25.6), and CPR duration (OR, 1.20; 95% CI, 1.05-1.37). Conclusions Age younger than 1 year, shorter transport time, and longer dispatch time were associated with increased risk of death. Being pulseless upon discovery and receiving CPR were associated with new neurologic dysfunction. Maximizing EMS transport interventions for patients younger than 1 year requiring CPI may improve patient outcomes. |
| Databáze: | OpenAIRE |
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