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Pediatric cardiac arrest registries and survival outcomes: A European study
Franziska Markel1,2,3, Jana Djakow4,5, Dominique Biarent6
1Department of Congenital Heart Disease - Pediatric Cardiology, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353 Berlin, Germany.
Insights
Pediatric cardiac arrest registries are lacking in Europe, with significant variations in survival rates. Improved data collection through a European registry is crucial for understanding pediatric cardiac arrest epidemiology and outcomes.
Area of Science:
- Pediatric Emergency Medicine
- Cardiology
- Public Health Surveillance
Background:
- The epidemiology of pediatric cardiac arrest (PCA) across Europe remains largely uncharacterized.
- Existing data on PCA incidence and survival outcomes in Europe are scarce and fragmented.
Purpose of the Study:
- To characterize the landscape of pediatric cardiac arrest registries in Europe.
- To gather the first comprehensive survival outcome data for pediatric cardiac arrest in Europe.
Main Methods:
- A prospective multinational survey was conducted across 53 European countries.
- Data were collected on the existence, data points, and structure of pediatric out-of-hospital cardiac arrest (pOHCA) and pediatric in-hospital cardiac arrest (pIHCA) registries.
- Survival outcomes, including return of spontaneous circulation (ROSC) and survival to hospital discharge, were investigated from active registries.
Main Results:
- Only 13 European countries (39%) have an active PCA registry (11 for pOHCA, 8 for pIHCA).
- Data from 13 countries reported 17,708 pOHCAs and 2,743 pIHCAs, with wide variations in ROSC (10-72% for pOHCA, 60-72% for pIHCA) and survival (16-39% for pOHCA, 32-57% for pIHCA).
- Eleven countries expressed interest in European collaboration for registry data.
Conclusions:
- Less than 40% of European countries possess dedicated PCA registries, highlighting a significant gap in data collection.
- Reported survival rates for pediatric cardiac arrest exhibit considerable variability, particularly for pOHCA.
- There is a critical need for more systematic data collection, ideally via a unified European registry, to accurately determine PCA incidence and outcomes.
Objective:
The epidemiology of pediatric cardiac arrest in Europe is largely unknown. We aimed to characterize pediatric cardiac arrest registries and obtain the first survival outcome data on pediatric cardiac arrest in Europe.
Design:
This is a prospective multinational survey.
Setting:
We surveyed all 53 countries in Europe asking about: the existence registries for pediatric out-of-hospital cardiac arrest (pOHCA) and/or in-hospital cardiac arrest (pIHCA)), the data collected, and the structure of the registries. Subsequently, we investigated outcomes (number of pOHCA/pIHCA since start of the registry, return of spontaneous circulation (ROSC), survival to hospital discharge/30-day survival) from the countries with active registries.
Patients And Interventions:
We obtained information from 33 countries including 25 of the 27 European Union states.
Measurements And Main Results:
Thirteen countries (39%) have an ongoing pediatric cardiac arrest registry (pOHCA: 11 countries, pIHCA: 8 countries). All use the Utstein template for data collection. Five countries (15%) collect data about CPR quality. Eleven countries (33%) expressed interest in European collaboration on registry data. Overall, 13 countries reported data on outcomes from a total of 17,708 pOHCAs and 2,743 pIHCAs. The ROSC rate after pOHCA ranges from 10% to 72% as compared to 60% to 72% after pIHCA. Survival to hospital discharge ranges from 16% to 39% after pOHCA as compared to 32% to 57% after pIHCA.
Conclusions:
Less than 40% of the European countries have a pOHCA and/or pIHCA registry, reporting a wide variety in survival rates, especially after pOHCA. More systematic data collection is needed to identify the real incidence and outcomes from pediatric cardiac arrest, ideally through a joint European registry.
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