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.
BMC Emerg Med. 2023 Jun 20;23(1):69. doi: 10.1186/s12873-023-00839-1.
Cardiac 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).
This 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.
A 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].
Survival 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.
创伤后心脏骤停是导致死亡的主要原因，需要紧急治疗。本研究旨在调查和比较创伤性心脏骤停（TCA）和非创伤性心脏骤停（non-TCA）患者的发生率、预后因素和存活率。
本队列研究纳入了 2016 年至 2021 年期间丹麦所有院外心脏骤停患者。在院前医疗记录中识别 TCA，并与院外心脏骤停登记处相关联。主要结局为 30 天存活率，进行描述性和多变量分析。
共纳入 30215 例院外心脏骤停患者。其中 984 例（3.3%）为 TCA。TCA 患者较非 TCA 患者年轻且主要为男性（77.5% vs 63.6%，p < 0.01）。TCA 患者自主循环恢复率为 27.3%，而非 TCA 患者为 32.3%，p < 0.01，30 天存活率为 7.3%，而非 TCA 患者为 14.2%，p < 0.01。初始可除颤节律与存活率增加相关（TCA 患者的优势比[aOR]为 11.45，95%置信区间[6.24-21.24]）。与 TCA 相比，其他创伤和穿透性创伤与较低的存活率相关（aOR：0.2，95%置信区间[0.02-0.54]和 aOR：0.1，95%置信区间[0.03-0.31]），而非 TCA 与 aOR：3.47，95%置信区间[2.53-4.91]相关。
TCA 的存活率低于非 TCA。TCA 的预后预测因素与非 TCA 不同，这说明了心脏骤停病因的差异。初始可除颤节律可能与 TCA 的良好预后相关。
