Abstract 286: Resuscitation After Traumatic Cardiac Arrest
Introduction In severe trauma patients with cardiac arrest (CA), pre-hospital CPR is performed infrequently and resuscitation outcome is much worse compared to cardiac causes. The purpose of the present study is to analyze CPR outcome in trauma patients with CA using two large German Registries - the German Resuscitation Registry (GRR) and the Trauma Registry of the German Society for Trauma Surgery (TR-DGU).
Methods We combined two independent l registries to analyze outcome of trauma patients with CA. The GRR includes patients with pre-hospital CA followed by any resuscitation attempt, whereas the TR-DGU includes patients with severe trauma who reached a hospital alive. Combining both registries may have the potential to enable follow up of patients outcome from scene up to hospital discharge. Individual patients in both registries, however, were not identical.
Results and Conclusions Within the GRR database data from 368 (2.8%) trauma CA patients were identified out of 13,329 CA patients. Compared to CA patients with cardiac cause (n=8637), trauma patients had a mean age of 51.2 +/-22.4 years (vs. 68.4 +/-15.2 years in cardiac patients, p<0.001), initial return of spontaneous circulation could be restored in 107(29,1%) patients (vs. 3980 (46,1%) in cardiac patients), and 95 (25,8%) trauma patients had ROSC on admission at hospital (vs. 3673 (42,5%) in cardiac patients). Within the TR-DGU resuscitation attempts were reported in 814 trauma patients (3%) out of 27,592 documented trauma patients. The overall in-hospital mortality rate of these trauma CA patients was 72.9% (n=593 of 814). A two-step approach including both registries revealed that 13% survived 24 hours and 2% had good neurological outcome at hospital discharge out of 100% with a pre-clinical traumatic CA. Trauma patients with CA, however, were significant younger than CA patients with cardiac origin. Therefore, starting CPR in each CA patient, irrespective of the primary cause of CA, should be recommended.
- © 2011 by American Heart Association, Inc.