The survival of children who suffer cardiac arrest is poor. This study aimed to determine the predictors and outcome of cardiac arrest in paediatric patients presenting to an emergency department of a tertiary hospital in Tanzania. This was a prospective cohort study of paediatric patients > 1 month to ≤ 14 years presenting to Emergency Medicine Department of Muhimbili National Hospital (EMD) in Tanzania from September 2019 to January 2020 and triaged as Emergency and Priority. We enrolled consecutive patients during study periods where patients’ demographic and clinical presentation, emergency interventions and outcome were recorded. Logistic regression analysis was performed to identify the predictors of cardiac arrest. We enrolled 481 patients, 294 (61.1%) were males, and the median age was 2 years [IQR 1–5 years]. Among studied patients, 38 (7.9%) developed cardiac arrest in the EMD, of whom 84.2% were ≤ 5 years. Referred patients were over-represented among those who had an arrest (84.2%). The majority 33 (86.8%) of those who developed cardiac arrest died. Compromised circulation on primary survey (OR 5.9 (95% CI 2.1–16.6)), bradycardia for age on arrival (OR 20.0 (CI 1.6–249.3)), hyperkalemia (OR 8.2 (95% CI 1.4–47.7)), elevated lactate levels > 2 mmol/L (OR 5.2 (95% CI 1.4–19.7)), oxygen therapy requirement (OR 5.9 (95% CI 1.3–26.1)) and intubation within the EMD (OR 4.8 (95% CI 1.3–17.6)) were independent predictors of cardiac arrest. Thirty-eight children developed cardiac arrest in the EMD, with a very high mortality. Those who arrested were more likely to present with signs of hypoxia, shock and acidosis, which suggest they were at later stage in their illness. Outcomes can be improved by strengthening the pre-referral care and providing timely critical management to prevent cardiac arrest.

中文翻译：

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坦桑尼亚三级医院急诊科就诊的儿科患者心脏骤停的预测因素和结果

心脏骤停儿童的生存率很低。本研究旨在确定在坦桑尼亚一家三级医院急诊科就诊的儿科患者心脏骤停的预测因素和结果。这是一项前瞻性队列研究，对象为 2019 年 9 月至 2020 年 1 月在坦桑尼亚 Muhimbili 国家医院 (EMD) 急诊科就诊的年龄 > 1 个月至 ≤ 14 岁的儿科患者，并被分类为紧急和优先。我们在研究期间连续招募了患者，记录了患者的人口统计学和临床​​表现、紧急干预措施和结果。进行逻辑回归分析以确定心脏骤停的预测因素。我们招募了 481 名患者，其中 294 名 (61.1%) 为男性，中位年龄为 2 岁 [IQR 1-5 岁]。在研究的患者中，38 人（7.9%）在 EMD 发生心脏骤停，其中 84.2% ≤ 5 年。被转诊的患者在逮捕的患者中比例过高（84.2%）。大多数发生心脏骤停的人中有 33 人（86.8%）死亡。初步调查显示循环受损（OR 5.9 (95% CI 2.1–16.6)），到达年龄时心动过缓（OR 20.0 (CI 1.6–249.3)），高钾血症（OR 8.2 (95% CI 1.4–47.7)），乳酸升高水平 > 2 mmol/L (OR 5.2 (95% CI 1.4–19.7))，氧疗需求 (OR 5.9 (95% CI 1.3–26.1)) 和 EMD 内插管 (OR 4.8 (95% CI 1.3–17.6) ) 是心脏骤停的独立预测因子。38 名儿童在 EMD 中出现心脏骤停，死亡率非常高。被捕者更有可能出现缺氧、休克和酸中毒的迹象，这表明他们处于疾病晚期。