Relation of Medical History to the Pediatric Out-of-Hospital Cardiac Arrest Managed by Emergency Medical Services

Objective: The aim of this study was to examine the medical history of the pediatric out-of-hospital cardiac arrest (OHCA) patients to determine preexisting conditions that may relate to a later OHCA. Methods: The study was a retrospective population-based cohort study in Helsinki (population 595,000) served by a single emergency medical service (EMS) system. All OHCA patients aged between 0 and 17 met by the local EMS from 2002 to 2011 were included. Medical records of the Helsinki University Hospital and its clinics were examined to find preexisting medical or surgical conditions. Results: Forty-three patients experienced an EMS-treated OHCA. The annual incidence of an EMS-treated OHCA was 4.4 per 100,000 population younger than the age of 18 years. The mean age of patients was 7.9 years, largest age groups being younger than 1 year (30.2%) and 17 years (23.2%). The leading cause of OHCA was trauma (30.2%) followed by sudden infant death syndrome (18.6%) and cardiac reasons (14.0%). Nine patients (20.9%) survived to hospital, and 5 (11.6%) were discharged alive. Of the 43 patients, 28 (65.1%) had prior medical records in Helsinki University Hospital considering suspected or diagnosed chronic or otherwise significant conditions. The most common conditions were perinatal adaptation abnormalities (20.9%), psychiatric treatment (16.3%), and epilepsy (13.9%). Five patients had previous cardiac conditions. Trauma as a cause of OHCA was frequently represented among patients with prior psychiatric diagnosis or treatment. Among 17-year-old OHCA patients, 5 of 10 had psychiatric records. Conclusions: Majority of the patients had prior medical records. Psychiatric disorders were strongly presented.