Association between the relationship of bystander and neurologic recovery in pediatric out-of-hospital cardiac arrest

Aim: This study aimed to evaluate whether the relationship between bystanders and victims is associated with neurological outcomes in paediatric out-of-hospital cardiac arrest (OHCA). Methods: This cross-sectional, retrospective, observational study included patients with non-traumatic paediatric OHCA undergoing emergency medical service treatment between 2014 and 2021. The relationship between bystanders and patients was categorized into first responder, family, and layperson groups. The primary outcome was good neurological recovery. Further sensitivity analyses were conducted subcategorizing the cohort into four groups: first responder, family, friends or colleagues, and layperson, or two groups: family and non-family. Results: We analysed 1,451 patients. OHCAs in the family group showed lower rate of good neurological outcomes regardless of witness status: 29.4%, 12.3%, and 38.6% in the first responder, family, and layperson groups in the witnessed and 6.7%, 2.0%, and 7.3% in the unwitnessed cohort. Multivariable logistic regression yielded no significant differences between the three groups: the adjusted odds ratios (AOR) and 95% confidence interval (CI) were 0.57 (0.28-1.15) in the family and 1.18 (0.61-2.29) in the layperson compared to the first responder group. The sensitivity analysis yielded a higher probability of good neurologic recovery in the non-family compared to the family member bystander group in witnessed cohort (AOR, 1.96; 95% CI, 1.17-3.30). Conclusion: Paediatric OHCAs had no significant difference between good neurological recovery and the relationship of bystander.