Aim

The survival rate of patients with traumatic cardiac arrest is 3% or lower. Cardiac arrest witnessed by emergency medical services (EMS) accounts for approximately 16% of prehospital traumatic cardiac arrests, but the prognosis is unknown. We aimed to compare the 1-month survival rate of cardiac arrest witnessed by EMS with that of cardiac arrest witnessed by bystanders and unwitnessed cardiac arrest in traffic trauma victims; further, the time from injury to cardiac arrest was assessed.

Methods

This analysis used the Utstein Registry in Japan and included data of 3883 patients with traumatic cardiac arrest caused by traffic collisions registered between 2014 and 2019 in Japan.

Results

The 1-month survival rate was 10.9% in the EMS-witnessed cardiac arrest group; this was significantly higher than that in the bystander-witnessed (7.2%) and unwitnessed (5.6%) cardiac arrest groups (P < 0.01). The median time from injury to cardiac arrest was 18 min (25% quartile: 12, 75% quartile: 26).

Conclusion

The 1-month survival rate was significantly higher in the EMS-witnessed cardiac arrest group than in the bystander-witnessed and unwitnessed cardiac arrest groups. It is important to prevent progression to cardiac arrest in trauma patients with intact respiratory function and pulse rate at the time of contact with EMS. A system for early recognition of severe trauma is needed, and a doctor’s car or helicopter can be requested as needed. We believe that early recognition and prompt intervention will improve the prognosis of prehospital traumatic cardiac arrest.

中文翻译：

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EMS目击的交通事故导致的外伤性院外心脏骤停后的结果评估

目的

外伤性心脏骤停患者的存活率为3%或更低。由紧急医疗服务 (EMS) 见证的心脏骤停约占院前创伤性心脏骤停的 16%，但预后未知。我们的目的是比较 EMS 见证的心脏骤停的 1 个月存活率与旁观者见证的心脏骤停和交通创伤受害者的未见证心脏骤停的存活率；此外，还评估了从受伤到心脏骤停的时间。

方法

该分析使用日本的 Utstein Registry，包括 2014 年至 2019 年间在日本登记的 3883 名因交通碰撞导致的创伤性心脏骤停患者的数据。

结果

EMS目击心脏骤停组的1个月生存率为10.9%；这显着高于旁观者目击者（7.2%）和非目击者（5.6%）心脏骤停组（P  < 0.01）。从受伤到心脏骤停的中位时间为 18 分钟（25% 四分位数：12，75% 四分位数：26）。

结论

EMS目击心脏骤停组的1个月存活率显着高于旁观者目击和非目击心脏骤停组。在与 EMS 接触时呼吸功能和脉搏均完好的创伤患者，防止其进展为心脏骤停非常重要。需要一个早期识别严重创伤的系统，并且可以根据需要请求医生的汽车或直升机。我们相信早期识别和及时干预将改善院前外伤性心脏骤停的预后。