• Satoshi Matsui, Hiroshi Kurosawa, Takuro Hayashi, Hirokazu Takei, Naoko Tanizawa, Yasuhiro Ohnishi, Satoshi Murata, Masahumi Ohnishi, Henry YoshiiTakumaTDivision of Emergency Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan., Kosuke Miyawaki, Taisuke Matsumoto, Ryojiro Tanaka, Kosuke Kiyohara, Ling Zha, Tetsuhisa Kitamura, Tomotaka Sobue, and Masahiko Nitta.
• Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan; Division of Emergency Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan. Electronic address: matsui0620@gmail.com.
• Resuscitation. 2023 Oct 1; 191: 109942109942.

AimOut-of-hospital cardiac arrest (OHCA) has a poor prognosis in children; however, the annual patterns of prognosis and treatment have not been fully investigated.MethodsFrom the Japanese Association for Acute Medicine OHCA registry, a multicenter prospective observational registry in Japan, we identified pediatric patients (zero to 17 years old) between June 2014 and December 2019. The primary outcome was one-month survival. We investigated the annual patterns in patient characteristics, treatment, and one-month prognosis.ResultsDuring the study period, 1188 patients were eligible for analysis. For all years, the zero-year-old group accounted for a large percentage of the total population (between 30% and 40%). There were significant increases in the rates of bystander-initiated cardiopulmonary resuscitation (CPR; from 50.6% to 62.3%, p = 0.003), dispatcher instructions (from 44.7% to 65.7%, p = 0.001), and adrenaline administration (from 2.4% to 6.9%, p = 0.014) over time, whereas the rate of advanced airway management decreased significantly (from 17.7% to 8.8%, p = 0.003). The odds ratios for one-month survival adjusted for potential resuscitation factors also did not change significantly (from 7.1% to 10.3%, adjusted odds ratio for one-year increment = 0.98, confidence interval: 0.86-1.11).ConclusionDespite an increase in the rate of bystander-initiated CPR and pre-hospital adrenaline administration, there was no significant change in one-month survival.Copyright © 2023 Elsevier B.V. All rights reserved.

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