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Park J, Park SH, Kim C, Yoon SJ, Lim JH, Han JH, Shin JE, Eun HS, Park MS, Lee SM. Growth and developmental outcomes of infants with hypoxic ischemic encephalopathy. Sci Rep 2023; 13:23100. [PMID: 38155236 PMCID: PMC10754824 DOI: 10.1038/s41598-023-50187-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 12/16/2023] [Indexed: 12/30/2023] Open
Abstract
Despite advances in obstetric care, hypoxic ischemic encephalopathy (HIE) remains a significant disease burden. We determined the national trends of HIE prevalence, therapeutic hypothermia (TH) use, mortality, and outcomes from 2012 to 2019. This study included term infants diagnosed with HIE between 2012 and 2019 from the National Health Insurance Service database. The prevalence of HIE was 2.4 per 1000 births without significant change during the period. TH was performed in approximately 6.7% of infants with HIE, and the annual variation ranged from 2.4 to 12.5%. The mortality among all term infants with HIE was 4.6%. The mortality rate among infants with HIE and TH significantly declined from 40 to 16.9% during the eight years. Infants with TH had higher mortality, increased use of inhaled nitric oxide, and more invasive ventilator use, indicating greater disease severity in the TH group. Infants with TH also showed significantly poorer outcomes, including delayed development, cerebral palsy, sensorineural hearing loss, and seizure, compared to infants without TH (p < 0.0001). With the increasing application of TH, mortality and developmental outcomes among infants with HIE have been improving in the past eight years in Korea. Further efforts to improve outcomes should be needed.
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Affiliation(s)
- Joonsik Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Sook Hyun Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Chloe Kim
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - So Jin Yoon
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Joo Hee Lim
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Jung Ho Han
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Jeong Eun Shin
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Ho Seon Eun
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Min Soo Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea.
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Kim M, Yu J, Chang H, Heo S, Lee SU, Hwang SY, Yoon H, Cha WC, Shin TG, Kim T. National Surveillance of Pediatric Out-of-Hospital Cardiac Arrest in Korea: The 10-Year Trend From 2009 to 2018. J Korean Med Sci 2022; 37:e317. [PMID: 36377293 PMCID: PMC9667012 DOI: 10.3346/jkms.2022.37.e317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/13/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND This study reports trends in pediatric out-of-hospital cardiac arrest (OHCA) and factors affecting clinical outcomes by age group. METHODS We identified 4,561 OHCA patients younger than 18 years between January 2009 and December 2018 in the Korean OHCA Registry. The patients were divided into four groups: group 1 (1 year or younger), group 2 (1 to 5 years), group 3 (6 to 12 years), and group 4 (13 to 17 years). The primary outcome was survival to hospital discharge, and the secondary outcomes were return of spontaneous circulation (ROSC) at the emergency department (ED) and good neurological status at discharge. Multivariate logistic analyses were performed. RESULTS The incidence rate of pediatric OHCA in group 1 increased from 45.57 to 60.89 per 100,000 person-years, while that of the overall population decreased over the 10 years. The rates of ROSC at the ED, survival to hospital discharge, and good neurologic outcome were highest in group 4 (37.9%, 9.7%, 4.9%, respectively) and lowest in group 1 (28.3%, 7.1%, 3.2%). The positive factors for survival to discharge were event location of a public/commercial building or place of recreation, type of first responder, prehospital delivery of automated external defibrillator shock, initial shockable rhythm at the ED. The factors affecting survival outcomes differed by age group. CONCLUSION This study reports comprehensive trends in pediatric OHCA in the Republic of Korea. Our findings imply that preventive methods for the targeted population should be customized by age group.
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Affiliation(s)
- Minha Kim
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jaeyong Yu
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
- Digital and Smart Health Office, Tan Tock Seng Hospital (TTSH), Singapore
| | - Hansol Chang
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
| | - Sejin Heo
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
| | - Se Uk Lee
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Yeon Hwang
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Yoon
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Chul Cha
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
- Health Information and Strategy Center, Samsung Medical Center, Seoul, Korea
| | - Tae Gun Shin
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Taerim Kim
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Oh TK, Choi CW, Song IA. Epidemiologic study of in-hospital cardiopulmonary resuscitation among pediatric patients: A retrospective, population-based cohort study in South Korea. Medicine (Baltimore) 2022; 101:e30445. [PMID: 36086791 PMCID: PMC10980375 DOI: 10.1097/md.0000000000030445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/29/2022] [Indexed: 11/25/2022] Open
Abstract
We aimed to examine the clinical trends of in-hospital cardiopulmonary resuscitation (ICPR) and factors associated with live discharge following ICPR. As a national population-based cohort study, data were extracted from the South Korean National Inpatient Database. This study included 8992 pediatric patients under 18 years of age who underwent ICPR due to in-hospital cardiac arrest during hospitalization in South Korea between 2010 and 2019 (10 years). The annual prevalence, survival, duration of hospitalization, and total cost of hospitalization at ICPR were examined as clinical trends. In 2010, 7.94 per 100,000 pediatric patients received ICPR; the prevalence increased to 11.51 per 100,000 pediatric patients in 2019. The 10-year survival rates were similar, and the in-hospital, 6-month, and 1-year survival rates over 10 years were 44.0%, 34.0%, and 32.4%, respectively. The mean length of hospital stay at ICPR in 2010 was 20.7 (95% confidence interval [CI]: 19.3-22.2) days; this decreased to 16.6 (95% CI: 15.2-18.0) days in 2019. The mean total cost at ICPR was 11,081.1 (95% CI: 10,216.2-11,946.1) United States Dollars (USD) in 2010; this increased to 22,629.4 (95% CI: 20,588.3-24,670.5) USD in 2019. The prevalence of ICPR increased among pediatric patients in South Korea between 2010 and 2019; however, the survival rates were similar for the 10 years. The length of hospital stay at ICPR gradually decreased from 2010 through 2019, while the total cost of hospitalization at ICPR has gradually increased between 2010 and 2019.
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Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea
| | - Chang Won Choi
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - In-Ae Song
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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