Demographics, management, and outcomes of out-of-hospital traumatic cardiac arrest: a retrospective cohort study comparing children and adults.

AIM

Out-of-hospital traumatic cardiac arrests (TCA) are associated with a poor prognosis, yet limited research focuses on paediatric TCA. This study aimed to compare outcomes following TCA between children and adults.

METHODS

We conducted a retrospective cohort study using data from the French cardiac arrest registry (RéAC) between July 2011 and March 2023. We included all patients under 65 years who suffered a TCA managed by a mobile medical team. Patients were categorized as children (<18 years) and adults (18-65 years). The primary endpoint was the 30-day survival, and secondary endpoints were: return of spontaneous circulation (ROSC), survival at hospital admission and survival with a favourable neurological outcome (Cerebral Performance Categories 1-2) at 30 days.

RESULTS

Among 5,030 included patients, 396 were children (median age 13 [IQR 4-16] years; 73.2% male) and 4,634 were adults (median age 39 [IQR 27-51] years; 80.4% male). Paediatric patients had significantly higher rates of ROSC (25.5% vs. 20.6%,  = 0.02), survival to hospital admission (21.2% vs. 14.7%,  < 0.001), and 30-day survival (3.5% vs. 1.6%,  < 0.01). However, the proportion of patients achieving a favourable neurological outcome at 30 days did not differ significantly between groups (0.8% vs. 0.9%,  = 0.80).

CONCLUSIONS

Paediatric patients with out-of-hospital TCA demonstrate higher rates of ROSC and survival compared to adults, although neurological outcomes remain poor in both populations. These findings underscore age-related disparities in TCA prognosis and highlight the need for age-specific research in TCA patients.