Demographics of Pediatric OHCA Survivors With Postdischarge Diseases: A National Population-Based Follow-Up Study

Tsung-Han Lee; I-Cheng Juan; Hsiu-Ying Hsu; Wen-Liang Chen; Cheng-Chieh Huang; Mei-Chueh Yang; Wei-Yuan Lei; Chih-Ming Lin; Chu-Chung Chou; Chin-Fu Chang; Yan-Ren Lin

doi:10.3389/fped.2019.00537

Demographics of Pediatric OHCA Survivors With Postdischarge Diseases: A National Population-Based Follow-Up Study

Front Pediatr. 2020 Jan 24:7:537. doi: 10.3389/fped.2019.00537. eCollection 2019.

Authors

Tsung-Han Lee^{1

2}, I-Cheng Juan¹, Hsiu-Ying Hsu^{1

3

4}, Wen-Liang Chen², Cheng-Chieh Huang^{1

2}, Mei-Chueh Yang¹, Wei-Yuan Lei¹, Chih-Ming Lin^{5

6

7}, Chu-Chung Chou^{1

8

9}, Chin-Fu Chang¹, Yan-Ren Lin^{1

8

9}

Affiliations

¹ Department of Emergency Medicine, Changhua Christian Hospital, Changhua City, Taiwan.
² Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
³ Department of Nursing, Dayeh University, Changhua City, Taiwan.
⁴ Department of Nursing, Changhua Christian Hospital, Changhua City, Taiwan.
⁵ Department of Neurology, Changhua Christian Hospital, Changhua City, Taiwan.
⁶ Department of Social Work and Child Welfare, Providence University, Taichung City, Taiwan.
⁷ Department of Medicinal Botanicals and Health Applications, Dayeh University, Changhua City, Taiwan.
⁸ School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
⁹ School of Medicine, Chung Shan Medical University, Taichung City, Taiwan.

Abstract

Background: Postdischarge diseases (PDDs) have been reported for adult survivors of out-of-hospital cardiac arrest (OHCA). However, the detailed demographics of pediatric OHCA survivors with PDDs are not well-documented, and information regarding functional survivors is particularly limited. We aimed to report detailed information on the PDDs of survivors of traumatic and non-traumatic pediatric OHCA using a national healthcare database. Methods: We retrospectively obtained data from the Taiwan government healthcare database (2011-2015). Information on the demographics of traumatic and non-traumatic pediatric OHCA survivors (<20 years) was obtained and reported. The patients who survived to discharge (survivors) and those classified as functional survivors were followed up for 1 year for the analysis of newly diagnosed PDDs. The time from discharge to PDD diagnosis was also reported. Results: A total of 2,178 non-traumatic and 288 traumatic OHCA pediatric cases were included. Among the non-traumatic OHCA survivors (n = 374, survival rate = 17.2%), respiratory tract (n = 270, 72.2%), gastrointestinal (n = 187, 50.0%), and neurological diseases (n = 167, 49.1%) were the three most common PDD categories, and in these three categories, the majority of PDDs were atypical/influenza pneumonia, non-infective acute gastroenteritis, and generalized/status epilepsy, respectively. Among the traumatic OHCA survivors (n = 21, survival rate = 7.3%), respiratory tract diseases (n = 17, 81.0%) were the most common, followed by skin or soft tissue (n = 14, 66.7%) diseases. Most functional survivors still suffered from neurological and respiratory tract diseases. Most PDDs, except for skin or soft tissue diseases, were newly diagnosed within the first 3 months after discharge. Conclusions: Respiratory tract (pneumonia), neurological (epilepsy), and skin or soft tissue (dermatitis) diseases were very common among both non-traumatic and traumatic OHCA survivors. More importantly, most PDDs, except for skin or soft tissue diseases, were newly diagnosed within the first 3 months after discharge.

Keywords: OHCA; children; functional; neurological; postdischarge; survival.