Survival after traumatic cardiac arrest is possible—a comparison of German patient-registries
Abstract Background Out-of-hospital cardiac arrest (OHCA) due to trauma is rare, and survival in this group is infrequent. Over the last decades, several new procedures have been implemented to increase survival, and a “Special circumstances chapter” was included in the European Resuscitation Counci...
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12873-022-00714-5 |
| _version_ | 1828113099275632640 |
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| author | Stephan Seewald Jan Wnent Jan-Thorsten Gräsner Ingvild Tjelmeland Matthias Fischer Andreas Bohn Bertil Bouillon Holger Maurer Rolf Lefering |
| author_facet | Stephan Seewald Jan Wnent Jan-Thorsten Gräsner Ingvild Tjelmeland Matthias Fischer Andreas Bohn Bertil Bouillon Holger Maurer Rolf Lefering |
| author_sort | Stephan Seewald |
| collection | DOAJ |
| description | Abstract Background Out-of-hospital cardiac arrest (OHCA) due to trauma is rare, and survival in this group is infrequent. Over the last decades, several new procedures have been implemented to increase survival, and a “Special circumstances chapter” was included in the European Resuscitation Council (ERC) guidelines in 2015. This article analysed outcomes after traumatic cardiac arrest in Germany using data from the German Resuscitation Registry (GRR) and the TraumaRegister DGU® (TR-DGU) of the German Trauma Society. Methods In this study, data from patients with OHCA between 01.01.2014 and 31.12.2019 secondary to major trauma and where cardiopulmonary resuscitation (CPR) was started were eligible for inclusion. Endpoints were return of spontaneous circulation (ROSC), hospital admission with ROSC and survival to hospital discharge. Results 1.049 patients were eligible for inclusion. ROSC was achieved in 28.7% of the patients, 240 patients (22.9%) were admitted to hospital with ROSC and 147 (14.0%) with ongoing CPR. 643 (67.8%) patients were declared dead on scene. Of all patients resuscitated after traumatic OHCA, 27.3% (259) died in hospital. The overall mortality was 95.0% and 5.0% survived to hospital discharge (47). In a multivariate logistic regression analysis; age, sex, injury severity score (ISS), head injury, found in cardiac arrest, shock on admission, blood transfusion, CPR in emergency room (ER), emergency surgery and initial electrocardiogram (ECG), were independent predictors of mortality. Conclusion Traumatic cardiac arrest was an infrequent event with low overall survival. The mortality has remained unchanged over the last decades in Germany. Additional efforts are necessary to identify reversible cardiac arrest causes and provide targeted trauma resuscitation on scene. Trial registration DRKS, DRKS-ID DRKS00027944. Retrospectively registered 03/02/2022. |
| first_indexed | 2024-04-11T12:01:16Z |
| format | Article |
| id | doaj.art-e06ef0c0788c4e61a3e728dd5a52bca0 |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-04-11T12:01:16Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-e06ef0c0788c4e61a3e728dd5a52bca02022-12-22T04:24:52ZengBMCBMC Emergency Medicine1471-227X2022-09-012211910.1186/s12873-022-00714-5Survival after traumatic cardiac arrest is possible—a comparison of German patient-registriesStephan Seewald0Jan Wnent1Jan-Thorsten Gräsner2Ingvild Tjelmeland3Matthias Fischer4Andreas Bohn5Bertil Bouillon6Holger Maurer7Rolf Lefering8Institute for Emergency Medicine, University Hospital Schleswig-HolsteinInstitute for Emergency Medicine, University Hospital Schleswig-HolsteinInstitute for Emergency Medicine, University Hospital Schleswig-HolsteinInstitute for Emergency Medicine, University Hospital Schleswig-HolsteinDepartment of Anesthesiology, Intensive Care Medicine and Emergency Medicine, ALB-FILS KlinikenCity of Muenster, Fire DepartmentDepartment of Trauma and Orthopedic Surgery, Cologne Merheim Medical CenterDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-HolsteinInstitute for Research in Operative Medicine, Faculty of Health, University of Witten/HerdeckeAbstract Background Out-of-hospital cardiac arrest (OHCA) due to trauma is rare, and survival in this group is infrequent. Over the last decades, several new procedures have been implemented to increase survival, and a “Special circumstances chapter” was included in the European Resuscitation Council (ERC) guidelines in 2015. This article analysed outcomes after traumatic cardiac arrest in Germany using data from the German Resuscitation Registry (GRR) and the TraumaRegister DGU® (TR-DGU) of the German Trauma Society. Methods In this study, data from patients with OHCA between 01.01.2014 and 31.12.2019 secondary to major trauma and where cardiopulmonary resuscitation (CPR) was started were eligible for inclusion. Endpoints were return of spontaneous circulation (ROSC), hospital admission with ROSC and survival to hospital discharge. Results 1.049 patients were eligible for inclusion. ROSC was achieved in 28.7% of the patients, 240 patients (22.9%) were admitted to hospital with ROSC and 147 (14.0%) with ongoing CPR. 643 (67.8%) patients were declared dead on scene. Of all patients resuscitated after traumatic OHCA, 27.3% (259) died in hospital. The overall mortality was 95.0% and 5.0% survived to hospital discharge (47). In a multivariate logistic regression analysis; age, sex, injury severity score (ISS), head injury, found in cardiac arrest, shock on admission, blood transfusion, CPR in emergency room (ER), emergency surgery and initial electrocardiogram (ECG), were independent predictors of mortality. Conclusion Traumatic cardiac arrest was an infrequent event with low overall survival. The mortality has remained unchanged over the last decades in Germany. Additional efforts are necessary to identify reversible cardiac arrest causes and provide targeted trauma resuscitation on scene. Trial registration DRKS, DRKS-ID DRKS00027944. Retrospectively registered 03/02/2022.https://doi.org/10.1186/s12873-022-00714-5Traumatic cardiac arrestResuscitationGerman resuscitation registryGRRTrauma registryTR-DGU |
| spellingShingle | Stephan Seewald Jan Wnent Jan-Thorsten Gräsner Ingvild Tjelmeland Matthias Fischer Andreas Bohn Bertil Bouillon Holger Maurer Rolf Lefering Survival after traumatic cardiac arrest is possible—a comparison of German patient-registries BMC Emergency Medicine Traumatic cardiac arrest Resuscitation German resuscitation registry GRR Trauma registry TR-DGU |
| title | Survival after traumatic cardiac arrest is possible—a comparison of German patient-registries |
| title_full | Survival after traumatic cardiac arrest is possible—a comparison of German patient-registries |
| title_fullStr | Survival after traumatic cardiac arrest is possible—a comparison of German patient-registries |
| title_full_unstemmed | Survival after traumatic cardiac arrest is possible—a comparison of German patient-registries |
| title_short | Survival after traumatic cardiac arrest is possible—a comparison of German patient-registries |
| title_sort | survival after traumatic cardiac arrest is possible a comparison of german patient registries |
| topic | Traumatic cardiac arrest Resuscitation German resuscitation registry GRR Trauma registry TR-DGU |
| url | https://doi.org/10.1186/s12873-022-00714-5 |
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