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KMID : 1100620200070010014
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Clinical and Experimental Emergency Medicine
2020 Volume.7 No. 1 p.14 ~ p.20
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Prognostic factors related with outcomes in traumatic out-of-hospital cardiac arrest patients without prehospital return of spontaneous circulation: a nationwide observational study
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Jun Gwang-Soo
Kim Jae-Guk
Choi Hyun-Young
Kang Gu-Hyun
Kim Won-Hee
Jang Yong-Soo
Kim Hyun-Tae
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Abstract
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Objective: To evaluate the prognostic factors associated with the sustained return of spontaneous circulation (ROSC) and survival to hospital discharge in traumatic out-of-hospital cardiac arrest (TOHCA) patients without prehospital ROSC.
Methods: We analyzed Korean nationwide data from the Out-of-Hospital Cardiac Arrest Surveillance, and included adult TOHCA patients without prehospital ROSC from January 2012 to December 2016. The primary outcome was sustained ROSC (>20 minutes). The secondary outcome was survival to discharge. Multivariate analysis was performed to investigate factors associated with the outcomes of TOHCA patients.
Results: Among 142,905 cases of OHCA, 8,326 TOHCA patients were investigated. In multivariate analysis, male sex (odds ratio [OR], 1.326; 95% confidence interval [CI], 1.103?1.594; P=0.003), and an initial shockable rhythm (OR, 1.956; 95% CI, 1.113?3.439; P=0.020) were significantly associated with sustained ROSC. Compared with traffic crash, collision (OR, 1.448; 95% CI, 1.086?1.930; P=0.012) was associated with sustained ROSC. Fall (OR, 0.723; 95% CI, 0.589? 0.888; P=0.002) was inversely associated with sustained ROSC. Male sex (OR, 1.457; 95% CI, 1.026?2.069; P=0.035) and an initial shockable rhythm (OR, 4.724; 95% CI, 2.451?9.106; P<0.001) were significantly associated with survival to discharge. Metropolitan city (OR, 0.728; 95% CI, 0.541?0.980; P=0.037) was inversely associated with survival to discharge. Compared with traffic crash, collision (OR, 1.745; 95% CI, 1.125?2.708; P=0.013) was associated with survival to discharge.
Conclusion: Male sex, an initial shockable rhythm, and collision could be favorable factors for sustained ROSC, whereas fall could be an unfavorable factor. Male sex, non-metropolitan city, an initial shockable rhythm, and collision could be favorable factors in survival to discharge.
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KEYWORD
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Out-of-hospital cardiac arrest, Wounds and injuries, Survival, Prognosis, Observational study
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