Risk stratification of survival in injured patients with cardiopulmonary resuscitation within the first hour of arrival to trauma centre: retrospective analysis from the national trauma data bank

Abstract

Approximately 13% of patients who had CPR within an hour of arrival to a trauma centre survived their injury. Therefore, implementation of an aggressive first hour in-hospital resuscitation strategy may result in better survival outcomes for this patient population.

Factors associated with survival in Adult Patients with Traumatic Arrest: A Retrospective Cohort Study from US Trauma Centers

“…This differs from previous studies 5,16,19 where no similar associations were reported. Patients in the younger age are usually expected to have better odds of survival because of lower comorbidities.…”

“…13,16 Young, white and male individuals continue to be mostly affected by traumatic arrests. 1,5,11 Improved survival in traumatic arrests presenting to U.S hospitals has been previously attributed to the increasing frequency of emergency interventions such as ED thoracotomy and other procedures. 17 Variation in survival rates of patients with traumatic arrest is however mostly related to differences in study sample selections with most studies including in the denominator arrests that are not transported to hospitals.…”

“…2 Prior studies that examined traumatic arrests have reported very low survival rates ranging from 1.5% to 12.5 %. [3][4][5] Guidelines to withhold resuscitative measures speci c for traumatic arrests have also been proposed in previous studies and by major organizations such as National Association of Emergency Medical Services Physicians and the American College of Surgeons Committee on Trauma (NAEMSP/ACS-COT) because of the futility of resuscitative measures for this condition. 6,7 Survival has however been increasing with the improvement of medical interventions as well as the establishment of trauma systems.…”

“…8,9 Previously identi ed factors that may contribute to increased survival in traumatic arrests include emergency department thoracotomy, 9 presence of VF on admission, 10,11 witnessed TA, 11 pre-hospital chest decompression, 12 admission to trauma center, 5,13 lower injury severity score (ISS), high Glasgow Coma score, Caucasian race and higher systolic blood pressure (SBP). 5 With evolving trauma care, improved survival is expected and factors associated with survival might change. This study used the 2015 dataset from the US National Trauma Databank 1) to examine characteristics and outcomes of patients suffering from traumatic arrests and 2) to identify factors associated with survival in traumatic arrests victims who were treated in US trauma centers.…”

Part 2. Clinical Practice Guideline for Trauma Team Composition and Trauma Cardiopulmonary Resuscitation from the Korean Society of Traumatology

“…In a previous study conducted throughout the 1980s to the 1990s, the ERC reported that cardiac arrest trauma patients had a survival rate below 2%. However, according to a German and American study conducted using cardiac arrest trauma patients from the DGU registry, the survival rate of such patients was 17.2% and 13% respec-tively, a higher rate than was previously thought [55,56]. It must be noted, though, that the American study only included cardiac arrest patients who arrived within the ICU bay within 1 hour.…”