The Epidemiology of Paediatric Out-of-Hospital Cardiac Arrest in Australia and New Zealand: A Report from The Australasian Resuscitation Outcomes Consortium Epistry (Aus-ROC).
Resuscitation · 2026-10-09 · Registry study
Abstract
BACKGROUND: This first epidemiological study of paediatric out-of-hospital cardiac arrest (pOHCA) across Australia and New Zealand explores the incidence, patient and event characteristics, both overall and by developmental age groups, and examines factors associated with outcomes. METHODS: All pOHCAs (aged <18 years) attended by emergency medical services (EMS) in Australia and New Zealand from 2017 to 2023 were included. Crude incidence rates (per 100,000 person-years) were calculated for EMS-attended and EMS-treated cases. Logistic regression models were used to identify associations between patient and arrest characteristics and survival (event and 30-day/hospital discharge). RESULTS: EMS attended 4,779 cases and treated 3,139 (65.7%). Incidence rates for EMS-attended and EMS-treated cases were 10.1 and 6.6, respectively; with a bimodal age distribution peaking in infants (65.4) and adolescents (11.4). Most EMS-attended cases were unwitnessed (66.9%), of medical origin (60.1%), had initial non-shockable rhythms (91.1%), occurred in private residences (74.3%), and received bystander cardiopulmonary resuscitation (62.7%). Few (1.6%) received bystander defibrillation. Arrest characteristics varied widely between age groups. Survival to 30-days/hospital discharge in EMS-treated cases was 10.0% (highest in late childhood [15.4%] and lowest in infants [7.9%]). Multivariable analysis identified that increasing age was positively associated with event survival, whilst bystander-witnessed arrest, initial shockable rhythm, arrest aetiology, and EMS response time were significant predictors of short and long-term survival. CONCLUSION: The incidence, patient characteristics, and survival outcomes of pOHCA in our region differ significantly by age groups. Age- and context-specific prevention and resuscitation strategies are essential for reducing the burden and improving survival outcomes.
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Tags
Children · Mortality & survival · Time intervals
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