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. 2023 Jun 20;23(1):69.
doi: 10.1186/s12873-023-00839-1.

Traumatic cardiac arrest - a nationwide Danish study

Signe Amalie Wolthers  1   2 , Theo Walther Jensen  3 , Niklas Breindahl  3   4   5 , Louise Milling  6   7 , Stig Nikolaj Blomberg  3 , Lars Bredevang Andersen  3 , Søren Mikkelsen  6   7 , Christian Torp-Pedersen  8   9   10 , Helle Collatz Christensen  3   4   11
Affiliations

Traumatic cardiac arrest - a nationwide Danish study

Signe Amalie Wolthers et al. BMC Emerg Med. .

Abstract

Background: Cardiac arrest following trauma is a leading cause of death, mandating urgent treatment. This study aimed to investigate and compare the incidence, prognostic factors, and survival between patients suffering from traumatic cardiac arrest (TCA) and non-traumatic cardiac arrest (non-TCA).

Methods: This cohort study included all patients suffering from out-of-hospital cardiac arrest in Denmark between 2016 and 2021. TCAs were identified in the prehospital medical record and linked to the out-of-hospital cardiac arrest registry. Descriptive and multivariable analyses were performed with 30-day survival as the primary outcome.

Results: A total of 30,215 patients with out-of-hospital cardiac arrests were included. Among those, 984 (3.3%) were TCA. TCA patients were younger and predominantly male (77.5% vs 63.6%, p = < 0.01) compared to non-TCA patients. Return of spontaneous circulation occurred in 27.3% of cases vs 32.3% in non-TCA patients, p < 0.01, and 30-day survival was 7.3% vs 14.2%, p < 0.01. An initial shockable rhythm was associated with increased survival (aOR = 11.45, 95% CI [6.24 - 21.24] in TCA patients. When comparing TCA with non-TCA other trauma and penetrating trauma were associated with lower survival (aOR: 0.2, 95% CI [0.02-0.54] and aOR: 0.1, 95% CI [0.03 - 0.31], respectively. Non-TCA was associated with an aOR: 3.47, 95% CI [2.53 - 4,91].

Conclusion: Survival from TCA is lower than in non-TCA. TCA has different predictors of outcome compared to non-TCA, illustrating the differences regarding the aetiologies of cardiac arrest. Presenting with an initial shockable cardiac rhythm might be associated with a favourable outcome in TCA.

Keywords: Epidemiology; Out-of-hospital cardiac arrest; Prehospital interventions; Resuscitation; Trauma.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Revised STROBE Flowchart of Inclusion
Fig. 2
Fig. 2
Multivariable analysis for 30-day Survival in Traumatic Cardiac Arrest in Denmark between 2016 and 2021 The analysis was adjusted for initial shockable rhythm, observation of occurrence, sex, age and location of the arrest. OR: Odds ratio
Fig. 3
Fig. 3
Multivariable analysis of 30-day mortality in traumatic cardiac arrest compared to non-traumatic cardiac arrest (reference) The analysis was adjusted for initial shockable rhythm, fall from less than two metres, fall from more than two metres, road collision, gunshot wound, burn, penetrating trauma, other trauma, male sex and age. OR: Odds ratio
See this image and copyright information in PMC

References

    1. Zwingmann J, Mehlhorn AT, Hammer T, Bayer J, Südkamp NP, Strohm PC. Survival and neurologic outcome after traumatic out-of-hospital cardiopulmonary arrest in a pediatric and adult population: a systematic review. Crit Care. 2012;16:R117. doi: 10.1186/cc11410. - DOI - PMC - PubMed
    1. Leis CC, Hernández CC, Blanco MJG-O, Paterna PCR, Hernández R de E, Torres EC. Traumatic cardiac arrest. J Trauma Acute Care Surg. 2013;74:634–8. doi: 10.1097/TA.0b013e31827d5d3c. - DOI - PubMed
    1. Evans CCD, Petersen A, Meier EN, Buick JE, Schreiber M, Kannas D, 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;81:285–293. doi: 10.1097/TA.0000000000001070. - DOI - PMC - PubMed
    1. Pfeifer R, Tarkin IS, Rocos B, Pape H-C. Patterns of mortality and causes of death in polytrauma patients—Has anything changed? Injury. 2009;40:907–911. doi: 10.1016/j.injury.2009.05.006. - DOI - PubMed
    1. Zwingmann J, Lefering R, Feucht M, Südkamp NP, Strohm PC, Hammer T. Outcome and predictors for successful resuscitation in the emergency room of adult patients in traumatic cardiorespiratory arrest. Crit Care. 2016;20:282. doi: 10.1186/s13054-016-1463-6. - DOI - PMC - PubMed

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