Abstract
Introduction
Pediatric out-of-hospital cardiac arrest (OHCA) is one of the most critical conditions
seen in the emergency department (ED). Although initial serum pH value is reported
to be associated with outcome in adult OHCA patients, the association is unclear in
pediatric OHCA patients. Thus, we aimed to identify the association between initial
pH value and outcome among pediatric OHCA patients.
Methods
This study was a retrospective analysis of a multicenter prospective cohort registry
(Japanese Association for Acute Medicine out-of-hospital cardiac arrest registry)
from 87 hospitals in Japan. We included pediatric OHCA patients younger than 16 years
of age who were registered in this registry between June 2014 and December 2017. Of
the 34,754 patients in the database, 458 patients were ultimately included in the
analysis. We equally divided the patients into four groups, based on their initial
pH value, and conducted a multivariate logistic regression analysis to calculate the
adjusted odds ratios of the initial pH value on hospital arrival with their 95% confidence
intervals for the primary outcome.
Results
The median (interquartile range) age was 1 (0–6) year, and 77.9% (357/458) of the
first monitored rhythm was asystole. The primary outcome was 1-month survival. The
overall 1-month survival was 13.3% (61/458), and a 1-month favorable neurologic outcome
was seen in 5.2% (24/458) of cases. The adjusted odds ratios and 95% confidence intervals
for the pH 6.81–6.64, pH 6.63–6.47, pH <6.47, and pH unknown groups compared with
the pH ≥6.82 group for 1-month survival were 0.39 (0.16–0.97), 0.13 (0.04–0.44), 0.03
(0.00–0.24), and 0.07 (0.02–0.21), respectively.
Conclusions
This study demonstrated the association between the initial pH value on hospital arrival
and 1-month survival among pediatric OHCA patients.
Keywords
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Article Info
Publication History
Published online: December 16, 2020
Accepted:
December 10,
2020
Received in revised form:
December 6,
2020
Received:
September 2,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
