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. 2022 Sep 16;9(1):e786.
doi: 10.1002/ams2.786. eCollection 2022 Jan-Dec.

Prehospital advanced airway management of emergency medical service-witnessed traumatic out-of-hospital cardiac arrest patients: analysis of nationwide trauma registry

Takeshi Nishimura  1   2 , Masafumi Suga  1   2 , Atsunori Nakao  1 , Satoshi Ishihara  2 , Hiromichi Naito  1
Affiliations

Prehospital advanced airway management of emergency medical service-witnessed traumatic out-of-hospital cardiac arrest patients: analysis of nationwide trauma registry

Takeshi Nishimura et al. Acute Med Surg. .

Abstract

Aim: Survival of traumatic out-of-hospital cardiac arrest (OHCA) is poor. Early use of advanced airway management (AAM) techniques, including endotracheal intubation and supraglottic devices, are expected to contribute to the improved survival of these patients. The aim of this study was to determine whether prehospital use of AAM improves the outcomes for emergency medical service (EMS)-witnessed traumatic OHCA.

Methods: A nationwide retrospective study was carried out. Trauma patients with EMS-witnessed cardiac arrest who received cardiopulmonary resuscitation during transport were included. Patients younger than 16 years and those with missing data were excluded. We compared two groups using propensity score matching. The primary outcome was survival to discharge. The secondary outcome was return of spontaneous circulation (ROSC) on hospital arrival. A logistic regression model was used to calculate odds ratios (OR) and confidence intervals (CI).

Results: After propensity score matching, 1,346 patients were enrolled (AAM 673 versus non-AAM 673). Forty-four AAM cases (6.5%) and 39 non-AAM cases (5.8%) survived. Logistic regression analysis did not show a contribution of AAM for survival to discharge (AAM 44/673 (6.5%), non-AAM 39/673 (5.8%); OR 1.12; 95% CI, 0.70-1.76; P = 0.64). However, AAM improved ROSC on admission (AAM 141/673 (21.0%), non-AAM 77/673 (11.4%); OR 2.05; 95% CI, 1.51-2.78; P < 0.001). This tendency was consistent throughout our subgroup analysis categorized by body region of the severe injury (head trauma, torso trauma, and extremity/spine trauma).

Conclusions: Prehospital AAM among EMS-witnessed traumatic OHCA patients was not associated with survival to discharge; however, ROSC on hospital admission improved for the AAM patients.

Keywords: AAM; Endotracheal intubation; JTDB; supraglottic airway; traumatic cardiac arrest.

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Figures

Fig. 1
Fig. 1
Flowchart of patients analyzed in the study. AAM, advanced airway management; AIS, Abbreviated Injury Scale; CPR, cardiopulmonary resuscitation; HR, heart rate; JTDB, Japan Trauma Data Bank; OHCA, out‐of‐hospital cardiac arrest; SBP, systolic blood pressure.
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References

    1. Lozano R, Naghavi M, Foreman K et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2095–128. - PMC - PubMed
    1. Stockinger ZT, McSwain NE Jr. Prehospital endotracheal intubation for trauma does not improve survival over bag‐valve‐mask ventilation. J. Trauma 2004; 56: 531–6. - PubMed
    1. Evans CC, Petersen A, Meier EN et al. Prehospital traumatic cardiac arrest: Management and outcomes from the resuscitation outcomes consortium epistry‐trauma and PROPHET registries. J. Trauma Acute Care Surg. 2016; 81: 285–93. - PMC - PubMed
    1. Willis CD, Cameron PA, Bernard SA, Fitzgerald M. Cardiopulmonary resuscitation after traumatic cardiac arrest is not always futile. Injury 2006; 37: 448–54. - PubMed
    1. Shimazu S, Shatney CH. Outcomes of trauma patients with no vital signs on hospital admission. J. Trauma 1983; 23: 213–6. - PubMed