Abstract 16743: Limitations of the Utstein Variables in Predicting Outcomes From Traumatic Out-of-hospital Cardiac Arrest
Background: Given low survival rates in cases of traumatic out-of-hospital cardiac arrest (OHCA), there is a need to identify factors that are associated with outcomes. In this study, we aimed to investigate Utstein factors that are associated with achieving a return of spontaneous circulation (ROSC) and survival to hospital in traumatic OHCA.
Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify all cases of traumatic OHCA that received attempted resuscitation and occurred between July 2008 and June 2014. We excluded cases <16 years of age or that had a mechanism of hanging or drowning.
Results: Of the 660 traumatic OHCA patients that received attempted resuscitation, ROSC was achieved in 159 patients (24%), 95 patients (14%) survived to hospital (ROSC on hospital handover) and 25 patients (4%) survived to hospital discharge. Factors that were positively associated with achieving ROSC in multivariable logistic regression models were age≥55 years (adjusted odds ratio (AOR)=1.54, 95% confidence interval (CI):1.03-2.32),arresting rhythm [shockable (AOR=3.66, 95%CI:1.66-8.10) and PEA (AOR=3.17, 95%CI:1.37-3.43) relative to asystole] and mechanism of injury [other/unknown (AOR=1.91, 95%CI:1.04-3.51) relative to motor vehicle collisions (MVCs)]. Similarly, factors positively associated with survival to hospital were age≥55 years (AOR=1.83, 95%CI:1.11-3.02), arresting rhythm [shockable (AOR=4.05, 95%CI:1.69-9.71) relative to asystole] and the injury mechanism [falls (AOR=2.12, 95%CI: 1.01-4.46) and other/unknown (AOR=2.19, 95%CI:1.05-4.54) relative to MVCs], while cases occurring in rural areas had lower odds relative to urban settings (AOR=0.32, 95%CI:0.15-0.68).
Conclusions: Our study demonstrated that of the Utstein variables, only age and arresting rhythm were associated with outcomes in traumatic OHCA. These findings suggest that 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.
Author Disclosures: B. Beck: None. J.E. Bray: None. P. Cameron: None. L. Straney: None. E. Andrew: Employment; Modest; Ambulance Victoria. S. Bernard: Employment; Modest; Ambulance Victoria. K. Smith: Employment; Modest; Ambulance Victoria.
- © 2016 by American Heart Association, Inc.