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Abstract：
To evaluate volume-outcome relationship in paediatric out-of-hospital cardiac arrest (OHCA).
This post hoc analysis of the SOS-KANTO 2012 study included data of paediatric OHCA patients <18 years old who were transported to the 53 emergency hospitals in the Kanto region of Japan between January 2012 and March 2013. Based on the paediatric OHCA case volume, the higher one-third of institutions (more than 10 paediatric OHCA cases during the study period) were defined as high-volume centres, the middle one-third institutions (6-10 cases) were defined as middle-volume centres and the lower one-third of institutions (less than 6 cases) were defined as low-volume centres. The primary outcome measurement was survival at 1 month after cardiac arrest. Multivariate logistic regression analysis for 1-month survival and paediatric OHCA case volume were performed after adjusting for multiple propensity scores. To estimate the multiple propensity score, we fitted a multinomial logistic regression model, which fell into one of the three groups as patient demographics and prehospital factors.
Among the eligible 282 children, 112, 82 and 88 patients were transported to the low-volume (36 institutions), middle-volume (11 institutions) and high-volume (6 institutions) centres, respectively. Transport to a high-volume centre was significantly associated with a better 1-month survival after adjusting for multiple propensity score (adjusted odds ratio, 2.55; 95% confidence interval, 1.05-6.17).
There may be a relationship between institutional case volume and survival outcomes in paediatric OHCA.
This post hoc analysis of the SOS-KANTO 2012 study included data of paediatric OHCA patients <18 years old who were transported to the 53 emergency hospitals in the Kanto region of Japan between January 2012 and March 2013. Based on the paediatric OHCA case volume, the higher one-third of institutions (more than 10 paediatric OHCA cases during the study period) were defined as high-volume centres, the middle one-third institutions (6-10 cases) were defined as middle-volume centres and the lower one-third of institutions (less than 6 cases) were defined as low-volume centres. The primary outcome measurement was survival at 1 month after cardiac arrest. Multivariate logistic regression analysis for 1-month survival and paediatric OHCA case volume were performed after adjusting for multiple propensity scores. To estimate the multiple propensity score, we fitted a multinomial logistic regression model, which fell into one of the three groups as patient demographics and prehospital factors.
Among the eligible 282 children, 112, 82 and 88 patients were transported to the low-volume (36 institutions), middle-volume (11 institutions) and high-volume (6 institutions) centres, respectively. Transport to a high-volume centre was significantly associated with a better 1-month survival after adjusting for multiple propensity score (adjusted odds ratio, 2.55; 95% confidence interval, 1.05-6.17).
There may be a relationship between institutional case volume and survival outcomes in paediatric OHCA.
摘要：
评估儿科院外心脏骤停（OHCA）的容量与结果的关系。
这项SOS-KANTO2012研究的事后分析包括2012年1月至2013年3月期间被送往日本关东地区53家急诊医院的18岁以下儿科OHCA患者的数据。根据儿科OHCA病例量，三分之一以上的机构（研究期间超过10例儿科OHCA病例）被定义为高容量中心，中间三分之一的机构(6-10例)被定义为中等容量中心，较低三分之一的机构(少于6例)被定义为低容量中心。主要结果是心脏骤停后1个月的生存率。校正多个倾向评分后，对1个月生存率和儿科OHCA病例量进行多因素logistic回归分析。要估计多重倾向得分，我们拟合了多项式逻辑回归模型，作为患者人口统计学和院前因素，它属于三组之一。
在符合条件的282名儿童中，112、82和88名患者被运送到小批量(36个机构)，中等数量(11个机构)和高数量(6个机构)中心，分别。在调整多个倾向评分（调整后的比值比，2.55；95%置信区间，1.05-6.17)。
儿科OHCA的机构病例量和生存结果之间可能存在关系。
这项SOS-KANTO2012研究的事后分析包括2012年1月至2013年3月期间被送往日本关东地区53家急诊医院的18岁以下儿科OHCA患者的数据。根据儿科OHCA病例量，三分之一以上的机构（研究期间超过10例儿科OHCA病例）被定义为高容量中心，中间三分之一的机构(6-10例)被定义为中等容量中心，较低三分之一的机构(少于6例)被定义为低容量中心。主要结果是心脏骤停后1个月的生存率。校正多个倾向评分后，对1个月生存率和儿科OHCA病例量进行多因素logistic回归分析。要估计多重倾向得分，我们拟合了多项式逻辑回归模型，作为患者人口统计学和院前因素，它属于三组之一。
在符合条件的282名儿童中，112、82和88名患者被运送到小批量(36个机构)，中等数量(11个机构)和高数量(6个机构)中心，分别。在调整多个倾向评分（调整后的比值比，2.55；95%置信区间，1.05-6.17)。
儿科OHCA的机构病例量和生存结果之间可能存在关系。
