Predicting outcomes in traumatic out-of-hospital cardiac arrest: The relevance of Utstein factors
Background: Given low survival rates in cases of traumatic out-of-hospital cardiac arrest (OHCA), there is a need to identify factors associated with outcomes. We aimed to investigate Utstein factors associated with achieving return of spontaneous circulation (ROSC) and survival to hospital in traum...
| Main Authors: | , , , , , , |
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| Format: | Journal Article |
| Published: |
BMJ Publishing Group
2017
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| Online Access: | http://hdl.handle.net/20.500.11937/61011 |
| _version_ | 1848760653660028928 |
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| author | Beck, B. Bray, Janet Cameron, P. Straney, L. Andrew, E. Bernard, S. Smith, K. |
| author_facet | Beck, B. Bray, Janet Cameron, P. Straney, L. Andrew, E. Bernard, S. Smith, K. |
| author_sort | Beck, B. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Given low survival rates in cases of traumatic out-of-hospital cardiac arrest (OHCA), there is a need to identify factors associated with outcomes. We aimed to investigate Utstein factors associated with achieving return of spontaneous circulation (ROSC) and survival to hospital in traumatic OHCA. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify cases of traumatic OHCA that received attempted resuscitation and occurred between July 2008 and June 2014. We excluded cases aged < 16 years or with a mechanism of hanging or drowning. Results: Of the 660 traumatic OHCA patients who received attempted resuscitation, ROSC was achieved in 159 patients (24%) and 95 patients (14%) survived to hospital (ROSC on hospital handover). Factors that were positively associated with achieving ROSC in multivariable logistic regression models were age =65 years (adjusted OR (AOR)=1.56, 95% CI: 1.01 to 2.43) and arresting rhythm (shockable (AOR=3.65, 95% CI: 1.64 to 8.11) and pulseless electrical activity (AOR=2.15, 95% CI: 1.36 to 3.39) relative to asystole). Similarly, factors positively associated with survival to hospital were arresting rhythm (shockable (AOR=3.92, 95% CI: 1.64 to 9.41) relative to asystole), and the mechanism of injury (falls (AOR=2.16, 95% CI: 1.03 to 4.54) relative to motor vehicle collisions), while trauma type (penetrating (AOR=0.27, 95% CI: 0.08 to 0.91) relative to blunt trauma) and event region (rural (AOR=0.39, 95% CI: 0.19 to 0.80) relative to urban) were negatively associated with survival to hospital. Conclusions: Few patient and arrest characteristics were associated with outcomes in traumatic OHCA. These findings suggest there is a need to incorporate additional information into cardiac arrest registries to assist prognostication and the development of novel interventions in these trauma patients. |
| first_indexed | 2025-11-14T10:19:12Z |
| format | Journal Article |
| id | curtin-20.500.11937-61011 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:19:12Z |
| publishDate | 2017 |
| publisher | BMJ Publishing Group |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-610112018-04-09T01:23:27Z Predicting outcomes in traumatic out-of-hospital cardiac arrest: The relevance of Utstein factors Beck, B. Bray, Janet Cameron, P. Straney, L. Andrew, E. Bernard, S. Smith, K. Background: Given low survival rates in cases of traumatic out-of-hospital cardiac arrest (OHCA), there is a need to identify factors associated with outcomes. We aimed to investigate Utstein factors associated with achieving return of spontaneous circulation (ROSC) and survival to hospital in traumatic OHCA. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify cases of traumatic OHCA that received attempted resuscitation and occurred between July 2008 and June 2014. We excluded cases aged < 16 years or with a mechanism of hanging or drowning. Results: Of the 660 traumatic OHCA patients who received attempted resuscitation, ROSC was achieved in 159 patients (24%) and 95 patients (14%) survived to hospital (ROSC on hospital handover). Factors that were positively associated with achieving ROSC in multivariable logistic regression models were age =65 years (adjusted OR (AOR)=1.56, 95% CI: 1.01 to 2.43) and arresting rhythm (shockable (AOR=3.65, 95% CI: 1.64 to 8.11) and pulseless electrical activity (AOR=2.15, 95% CI: 1.36 to 3.39) relative to asystole). Similarly, factors positively associated with survival to hospital were arresting rhythm (shockable (AOR=3.92, 95% CI: 1.64 to 9.41) relative to asystole), and the mechanism of injury (falls (AOR=2.16, 95% CI: 1.03 to 4.54) relative to motor vehicle collisions), while trauma type (penetrating (AOR=0.27, 95% CI: 0.08 to 0.91) relative to blunt trauma) and event region (rural (AOR=0.39, 95% CI: 0.19 to 0.80) relative to urban) were negatively associated with survival to hospital. Conclusions: Few patient and arrest characteristics were associated with outcomes in traumatic OHCA. These findings suggest there is a need to incorporate additional information into cardiac arrest registries to assist prognostication and the development of novel interventions in these trauma patients. 2017 Journal Article http://hdl.handle.net/20.500.11937/61011 10.1136/emermed-2016-206330 BMJ Publishing Group unknown |
| spellingShingle | Beck, B. Bray, Janet Cameron, P. Straney, L. Andrew, E. Bernard, S. Smith, K. Predicting outcomes in traumatic out-of-hospital cardiac arrest: The relevance of Utstein factors |
| title | Predicting outcomes in traumatic out-of-hospital cardiac arrest: The relevance of Utstein factors |
| title_full | Predicting outcomes in traumatic out-of-hospital cardiac arrest: The relevance of Utstein factors |
| title_fullStr | Predicting outcomes in traumatic out-of-hospital cardiac arrest: The relevance of Utstein factors |
| title_full_unstemmed | Predicting outcomes in traumatic out-of-hospital cardiac arrest: The relevance of Utstein factors |
| title_short | Predicting outcomes in traumatic out-of-hospital cardiac arrest: The relevance of Utstein factors |
| title_sort | predicting outcomes in traumatic out-of-hospital cardiac arrest: the relevance of utstein factors |
| url | http://hdl.handle.net/20.500.11937/61011 |