Incidence, aetiologies and survival outcomes of paediatric out-of-hospital cardiac arrest in Singapore.

INTRODUCTION

Paediatric out-of-hospital cardiac arrests (OHCA) result in poor survival outcomes globally. This study aims to present the incidence, aetiology and survival outcomes of paediatric OHCA in Singapore.

METHODS

Data on persons aged less than 18 years, who sustained OHCA in Singapore from 2010 to 2021, were extracted from the Pan Asian Resuscitation Outcomes Study (PAROS) Registry, a prospective international database of participating sites in 11 Asia-Pacific countries. The final aetiologies were obtained from the discharge summaries in the electronic medical records, and coroner's reports. Descriptive statistics were obtained for baseline characteristics, and survival outcomes. Multivariate analyses were performed to identify predictors of survival.

RESULTS

A total of 414 patients were analysed. The overall incidence of paediatric OHCA in Singapore was 4.62 per 100,000 person-years, with highest in infants less than 1 year old (33.5 per 100,000 person-years). Bystander CPR rate was 64.5% for the whole cohort. The most common aetiologies were respiratory (21%), drowning (20.2%) and trauma (18.5%). Overall, 35.5% of the patients had return of spontaneous circulation (ROSC), 11.1% of the patients had survival to 30 days and 8% had good neurological outcome (Cerebral Performance Category (CPC) 1 or 2). There was increase in 30-day survival for time period 2019 to 2021, compared with 2010 to 2012 (aOR 4.34; 95% CI 1.09-17.22; p = 0.037).

CONCLUSION

Incidence of paediatric OHCA in Singapore was 4.62 per 100,000 person-years. Most common aetiologies were respiratory, drowning and trauma. We observed improving trend of survival outcomes from 2010 to 2021 in Singapore.