Effects of regional differences on the outcome of cardiopulmonary resuscitation in children: How much different is Gaziantep from Izmir?
1Akdeniz University, Pediatrics, Emergency Care Unit, Antalya, Turkey
2Izmir Tepecik Hospital of Health Sciences University, Pediatrics, Emergency Care Unit, Izmir, Turkey
3Gaziantep Cengiz Gökçek Maternity and Pediatrics Hospital of Health Ministry, Pediatrics, Gaziantep, Turkey
Keywords: Cardiac arrest, cardiopulmonary resuscitation, children, lactate, prehospital, refugee
OBJECTIVES: We aimed to compare the demographic and clinical characteristics between pediatric cardiac arrest patients treated in Gaziantep at South-eastern Anatolian region and Izmir at Aegean Shore.
MATERIALS And METHODS: We retrospectively reviewed sociodemographic characteristics, laboratory parameters, and clinical outcomes of pediatric patients that underwent cardiopulmonary resuscitation due to prehospital cardiac arrest at two pediatric emergency departments in Izmir Hospital of Health Sciences University and Gaziantep Cengiz Gökçek Kadın Doğum ve Çocuk Hospital of Health Ministry between August 2017 and August 2018.
RESULTS: The present study included 188 patients (112 patients from Gaziantep and 76 patients from Izmir). All patients arrived at the hospital through emergency medical services. The median age was lower (14 days vs. 15 months; P < 0.001), and the proportion of Syrian refugees was higher in patients from Gaziantep (78.6% vs. 7.9%; P < 0,001). In both centers, respiratory failure was the most common etiology. In patients from Gaziantep, pH levels were lower (median: 7.10 vs. 7.24), and lactate levels were higher (median: 6 mmol/L vs. 3.6 mmol/L; P < 0.001). The mortality rate was higher among patients from Gaziantep (27.7% vs. 7.9%; P = 0.001).
CONCLUSIONS: The rate of Syrian refugees among children who were brought to emergency department due to pre-hospital cardiac arrest was much higher in Gaziantep compared to Izmir. Syrian children were significantly younger and had more severe tissue hypoxia, resulting in a higher mortality rate.
The study has ethical approval from Ethics Committees of Gaziantep University (approval#2018/191, 01.08.2018) and Gaziantep Local Health Authority (approval#65587614-774.99, 23.05.2019). This article does not contain any studies with human or animal subjects performed by any of the authors. The article contains no libelous or unlawful statements and does not contain any materials that violate any personal or proprietary rights of any other person or entity.
Taken according to ethical rules.
Conceptualization: OTK, MA, Design: OTK, MA, Data Collection or Processing: OTK, MA, SB, ŞD, EB, GG, GD, ŞB Analysis or Interpretation: OTK, MA, Literature Search: OTK, MA, Writing: OTK, MA. Each author has participated sufficiently in the work to take public responsibility for appropriate portions of the content.