Abstract
Aim
The survival rate of patients with traumatic cardiac arrest is 3% or lower. Cardiac
arrest witnessed by emergency medical services (EMS) accounts for approximately 16%
of prehospital traumatic cardiac arrests, but the prognosis is unknown. We aimed to
compare the 1-month survival rate of cardiac arrest witnessed by EMS with that of
cardiac arrest witnessed by bystanders and unwitnessed cardiac arrest in traffic trauma
victims; further, the time from injury to cardiac arrest was assessed.
Methods
This analysis used the Utstein Registry in Japan and included data of 3883 patients
with traumatic cardiac arrest caused by traffic collisions registered between 2014
and 2019 in Japan.
Results
The 1-month survival rate was 10.9% in the EMS-witnessed cardiac arrest group; this
was significantly higher than that in the bystander-witnessed (7.2%) and unwitnessed
(5.6%) cardiac arrest groups (P < 0.01). The median time from injury to cardiac arrest was 18 min (25% quartile:
12, 75% quartile: 26).
Conclusion
The 1-month survival rate was significantly higher in the EMS-witnessed cardiac arrest
group than in the bystander-witnessed and unwitnessed cardiac arrest groups. It is
important to prevent progression to cardiac arrest in trauma patients with intact
respiratory function and pulse rate at the time of contact with EMS. A system for
early recognition of severe trauma is needed, and a doctor’s car or helicopter can
be requested as needed. We believe that early recognition and prompt intervention
will improve the prognosis of prehospital traumatic cardiac arrest.
Keywords
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Article info
Publication history
Published online: December 23, 2021
Accepted:
December 21,
2021
Received in revised form:
December 2,
2021
Received:
October 1,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
