Abstract
This study aimed to identify neurologic prognostic factors after cardiac arrest in pediatric patients, focusing on clinical features and electroencephalography (EEG) findings. This is a retrospective single-center study. We analyzed resuscitated pediatric patients who admitted pediatric intensive care unit at a tertiary academic referral hospital in South Korea. Patients aged 1 month to 18 years with in-hospital cardiac arrest between January 2010 and October 2022 who received EEG within 7 days were included. The primary outcome was a favorable neurologic outcome, defined as a Pediatric Cerebral Performance Category score of 1-2, assessed at 6 months post-cardiac arrest. Sixty-two pediatric patients were included, with 16 (25.8%) achieving favorable outcomes. Multivariate logistic regression analyses identified initial shockable rhythm (p = 0.032), normal background voltage (p = 0.026), and continuous or nearly continuous background activity (p = 0.017) on standardized EEG as significant predictors of favorable neurologic outcomes at 6 months. The combination of an initial shockable rhythm with normal voltage or continuous EEG background enhanced prognostic accuracy (specificity = 100%). This study suggests that specific EEG background patterns-alpha frequency, normal voltage, and continuous or nearly continuous activity-within 1 week post-return of spontaneous circulation serve as indicators of favorable 6-month neurologic outcomes.