Traumatic cardiac arrest – a nationwide Danish study

BMC Emergency Medicine

Research

Christian Torp-Pedersen¹  Lars Bredevang Andersen²  Stig Nikolaj Blomberg²  Theo Walther Jensen²  Signe Amalie Wolthers³  Helle Collatz Christensen⁴  Niklas Breindahl⁵  Louise Milling⁶  Søren Mikkelsen⁶ 

[1] Department of Cardiology, Nordsjaellands Hospital, Hillerød, Denmark;Department of Cardiology, Herlev Gentofte University Hospital, Gentofte, Denmark;Department of Public Health, University of Copenhagen, Copenhagen, Denmark;Department of Clinical Medicine, Prehospital Center, Region Zealand, The University of Copenhagen, Ringstedgade 61, 13th floor, 4700, Naestved, Denmark;Department of Clinical Medicine, Prehospital Center, Region Zealand, The University of Copenhagen, Ringstedgade 61, 13th floor, 4700, Naestved, Denmark;Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark;Department of Clinical Medicine, Prehospital Center, Region Zealand, The University of Copenhagen, Ringstedgade 61, 13th floor, 4700, Naestved, Denmark;Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark;Danish Clinical Quality Program (RKKP), National Clinical Registries, Copenhagen, Denmark;Department of Clinical Medicine, Prehospital Center, Region Zealand, The University of Copenhagen, Ringstedgade 61, 13th floor, 4700, Naestved, Denmark;Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark;Department of Neonatal and Paediatric Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark;Department of Regional Health Research, Prehospital Research Unit, University of Southern Denmark, Odense, Denmark;Department of Anaesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark;

关键词: Trauma;    Out-of-hospital cardiac arrest;    Resuscitation;    Epidemiology;    Prehospital interventions;   

DOI  :  10.1186/s12873-023-00839-1

 received in 2022-12-28, accepted in 2023-06-01,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundCardiac 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).MethodsThis 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.ResultsA 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].ConclusionSurvival 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.

【 授权许可】

CC BY   
© The Author(s) 2023

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