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Traumatic cardiac arrest - a nationwide Danish study
Signe Amalie Wolthers1,2, Theo Walther Jensen3, Niklas Breindahl3,4,5
1Department of Clinical Medicine, Prehospital Center, Region Zealand, The University of Copenhagen, Ringstedgade 61, 13th floor, 4700, Naestved, Denmark. s.a.wolthers@gmail.com.
BMC Emergency Medicine
|June 20, 2023
Summary
Survival from traumatic cardiac arrest (TCA) is lower than non-traumatic cardiac arrest (non-TCA). Initial shockable rhythms may improve outcomes in TCA patients, highlighting distinct prognostic factors for cardiac arrest due to trauma.
Area of Science:
- Emergency Medicine
- Cardiology
- Trauma Surgery
Background:
- Traumatic cardiac arrest (TCA) is a significant cause of mortality, necessitating prompt medical intervention.
- Understanding the differences between TCA and non-traumatic cardiac arrest (non-TCA) is crucial for improving patient outcomes.
Purpose of the Study:
- To compare the incidence, prognostic factors, and survival rates of patients experiencing traumatic cardiac arrest (TCA) versus non-traumatic cardiac arrest (non-TCA).
Main Methods:
- A cohort study analyzed out-of-hospital cardiac arrest data in Denmark from 2016 to 2021.
- TCAs were identified via prehospital records and linked to the cardiac arrest registry.
- Descriptive and multivariable analyses focused on 30-day survival.
Main Results:
- Out of 30,215 out-of-hospital cardiac arrests, 984 (3.3%) were TCA.
- TCA patients were younger, predominantly male, and had lower 30-day survival (7.3% vs. 14.2%) compared to non-TCA.
- An initial shockable rhythm was linked to better survival in TCA (aOR=11.45), while other trauma and penetrating trauma were associated with lower survival.
Conclusions:
- Survival rates for TCA are significantly lower than for non-TCA.
- Prognostic factors for TCA differ from non-TCA, reflecting varied etiologies.
- An initial shockable cardiac rhythm may indicate a more favorable outcome in traumatic cardiac arrest.
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