Resuscitation after traumatic cardiac arrest –How many survivors do we have?
- Conditions
- T07Unspecified multiple injuries
- Registration Number
- DRKS00027944
- Lead Sponsor
- Deutsches Reanimationsregister der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin e.V. (DGAI)
- Brief Summary
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.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Complete
- Sex
- All
- Target Recruitment
- 3509
German Resuscitation Registry:
- traumatic out-of-hospital cardiac arrest between 01.01.2014 and 31.12.2019
- emergency medical services (EMS) with high data quality defined by
+ incidence of resuscitation started >30/100,000 inhabitants and year
+ any ROSC < 80%
+ ROSC-After-Cardiac-Arrest-score (RACA-score) calculable >60%
+ Documentation of hospital care (in case of hospital admission) >30%
German Traumaregistry:
- data from German hospitals
- Resuscitation by the EMS and hospital admission with ROSC
Missing values in relevant items
Study & Design
- Study Type
- observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Return of spontaneous circulation (ROSC), hospital admission with ROSC and survival to hospital discharged.
- Secondary Outcome Measures
Name Time Method Survival to hospital discharged with good neurological outcome