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Prehospital Factors Associated with Refractory Traumatic Arrest.

Jeong Hun Lee1, Yong Won Kim1, Tae Youn Kim1

  • 1Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea.

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Prehospital factors like asystole, no return of spontaneous circulation (ROSC), and high falls predict death in traumatic arrest patients. These findings aid in deciding when to terminate resuscitation efforts.

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Area of Science:

  • Emergency Medicine
  • Trauma Surgery
  • Prehospital Care

Background:

  • Traumatic arrest presents significant challenges in prehospital care.
  • Identifying factors predicting poor outcomes is crucial for resource allocation and treatment decisions.

Purpose of the Study:

  • To identify prehospital clinical factors associated with mortality in patients experiencing traumatic arrest.
  • To inform decisions regarding the termination of resuscitation in the emergency room.

Main Methods:

  • A multicenter retrospective study was conducted in South Korea from January 2016 to December 2018.
  • Adult trauma arrest patients arriving via ambulance, excluding those deceased on arrival, were analyzed.
  • Prehospital data and emergency room outcomes were collected and compared between survival and death groups.

Main Results:

  • Asystole was significantly associated with emergency room death (OR 4.033).
  • Prehospital return of spontaneous circulation (ROSC) was inversely related to emergency room death (OR 0.100).
  • For fall-related injuries, a fall height greater than 10 meters strongly predicted emergency room death.

Conclusions:

  • Asystole, absence of prehospital ROSC, and significant fall height are key predictors of mortality in traumatic arrest.
  • These clinical factors should be considered comprehensively when making decisions about resuscitation termination.