Hosomi Sanae, Kitamura Tetsuhisa, Sobue Tomotaka, Zha Ling, Kiyohara Kosuke, Oda Jun
Department of Traumatology and Acute Critical Medicine, Graduate School of Medicine, Osaka University, 2-15, Yamada-oka, Suita 565-0871, Japan.
Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita 565-0871, Japan.
J Clin Med. 2022 Feb 4;11(3):831. doi: 10.3390/jcm11030831.
The epidemiological and clinical characteristics, treatments, and outcomes of patients with traumatic out-of-hospital cardiac arrests (OHCAs) following traffic collisions have not been adequately investigated in Japan. We analyzed the All-Japan Utstein Registry data of 918 pediatric patients aged <20 years with OHCAs following traffic collisions who were resuscitated by bystanders or emergency medical service personnel and were subsequently transported to hospitals between 2013 and 2019. Multiple logistic regression analysis was used to assess factors potentially associated with 1-month survival after OHCA. The 1-month survival rate was 3.3% (30/918), and the rate of neurologically favorable outcomes was 0.7% (60/918). The proportion of 1-month survival of all OHCAs after traffic collision origin did not significantly increase (from 1.9% (3/162) in 2013 to 4.5% (5/111) in 2019), and the adjusted odds ratio (OR) for a 1-year increment was 1.13 (95% confidence interval (CI) 0.93 to 1.37). In a multivariate analysis, ventricular fibrillation arrests and pulseless electrical activity (PEA) were significant predictors of 1-month outcome after OHCAs due to traffic collision. From a large OHCA registry in Japan, we demonstrated that 1-month survival after OHCAs due to traffic collision origin was approximately 3%, and some children even gained full recovery of neurological function.
在日本，交通碰撞后发生创伤性院外心脏骤停（OHCA）患者的流行病学和临床特征、治疗方法及预后情况尚未得到充分研究。我们分析了全日本Utstein登记处的数据，这些数据来自2013年至2019年间918名年龄小于20岁、因交通碰撞发生OHCA且被旁观者或紧急医疗服务人员复苏后转运至医院的儿科患者。采用多因素逻辑回归分析评估与OHCA后1个月生存率可能相关的因素。1个月生存率为3.3%（30/918），神经功能良好预后率为0.7%（6/918）。交通碰撞导致的所有OHCA患者1个月生存率未显著提高（从2013年的1.9%（3/162）升至2019年的4.5%（5/111）），1年增加的调整优势比（OR）为1.13（95%置信区间（CI）0.93至1.37）。多因素分析中，心室颤动性心脏骤停和无脉电活动（PEA）是交通碰撞导致OHCA后1个月预后的显著预测因素。通过日本一个大型OHCA登记处的数据，我们证明交通碰撞导致OHCA后1个月生存率约为3%，一些儿童甚至实现了神经功能的完全恢复。
