Characteristics and Outcomes of Traumatic Cardiac Arrests in the Pan-Asian Resuscitation Outcomes Study

Lee MHM 1 , Chia MYC 1 , Fook-Chong S 2 , Shahidah N 3 , Tagami T 4 , Ryu HH 5 Show all authors , Lin CH 6 , Karim SA 7 , Jirapong S 8 , Rao HVR 9 , Cai W 10 , Velasco BP 11 , Khan NU 12 , Son DN 13 , Naroo GY 14 , El Sayed M 15 , Ong MEH 3

Affiliations 

  • 1 Emergency Department, Tan Tock Seng Hospital, Singapore, Singapore
  • 2 Prehospital Emergency & Research Centre, Duke-NUS Medical School, Singapore, Singapore
  • 3 Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
  • 4 Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
  • 5 Department of Emergency Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea
  • 6 Department of Emergency Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
  • 7 Department of Emergency Medicine, Hospital Sungai Buloh, Selangor, Malaysia
  • 8 Department of Emergency Medicine, Rajavithi Hospital, Bangkok, Thailand
  • 9 Emergency Medicine Learning Centre, GVK Emergency Management and Research Institute, Secunderabad, Telangana, India
  • 10 Department of Emergency Medicine, Zhejiang Provincial People's Hospital, Zhejiang, China
  • 11 Department of Emergency Medicine, Quezon City, Philippines
  • 12 Department of Emergency Medicine, Aga Khan University Hospital, Karachi, Pakistan
  • 13 Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Vietnam
  • 14 ED-Trauma Centre, Rashid Hospital, Dubai, United Arab Emirates
  • 15 Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Prehosp Emerg Care, 2023;27(8):978-986.
PMID: 35994382 DOI: 10.1080/10903127.2022.2113941

Abstract

OBJECTIVE: Little is known about survival outcomes after traumatic cardiac arrest in Asia, or the association of Utstein factors with survival after traumatic cardiac arrests. This study aimed to describe the epidemiology and outcomes of traumatic cardiac arrests in Asia, and analyze Utstein factors associated with survival.

METHODS: Traumatic cardiac arrest patients from 13 countries in the Pan-Asian Resuscitation Outcomes Study registry from 2009 to 2018 were analyzed. Multilevel logistic regression was performed to identify factors associated with the primary outcomes of survival to hospital discharge and favorable neurological outcome (Cerebral Performance Category (CPC) 1-2), and the secondary outcome of return of spontaneous circulation (ROSC).

RESULTS: There were 207,455 out-of-hospital cardiac arrest cases, of which 13,631 (6.6%) were trauma patients aged 18 years and above with resuscitation attempted and who had survival outcomes reported. The median age was 57 years (interquartile range 39-73), 23.0% received bystander cardiopulmonary resuscitation (CPR), 1750 (12.8%) had ROSC, 461 (3.4%) survived to discharge, and 131 (1.0%) had CPC 1-2. Factors associated with higher rates of survival to discharge and favorable neurological outcome were arrests witnessed by emergency medical services or private ambulances (survival to discharge adjusted odds ratio (aOR) = 2.95, 95% confidence interval (CI) = 1.99-4.38; CPC 1-2 aOR = 2.57, 95% CI = 1.25-5.27), bystander CPR (survival to discharge aOR = 2.16; 95% CI 1.71-2.72; CPC 1-2 aOR = 4.98, 95% CI = 3.27-7.57), and initial shockable rhythm (survival to discharge aOR = 12.00; 95% CI = 6.80-21.17; CPC 1-2 aOR = 33.28, 95% CI = 11.39-97.23) or initial pulseless electrical activity (survival to discharge aOR = 3.98; 95% CI = 2.99-5.30; CPC 1-2 aOR = 5.67, 95% CI = 3.05-10.53) relative to asystole.

CONCLUSIONS: In traumatic cardiac arrest, early aggressive resuscitation may not be futile and bystander CPR may improve outcomes.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

MeSH terms
Similar publications