Vianen, Niek Johannes;
Van Lieshout, Esther Maria Maartje;
Maissan, Iscander Michael;
Bramer, Wichor Matthijs;
Hartog, Dennis Den;
Verhofstad, Michael Herman Jacob;
Van Vledder, Mark Gerrit
Prehospital traumatic cardiac arrest: a systematic review and meta-analysis
You can manage bookmarks using lists, please log in to your user account for this.
Media type:
E-Article
Title:
Prehospital traumatic cardiac arrest: a systematic review and meta-analysis
Contributor:
Vianen, Niek Johannes;
Van Lieshout, Esther Maria Maartje;
Maissan, Iscander Michael;
Bramer, Wichor Matthijs;
Hartog, Dennis Den;
Verhofstad, Michael Herman Jacob;
Van Vledder, Mark Gerrit
Published:
Springer Science and Business Media LLC, 2022
Published in:
European Journal of Trauma and Emergency Surgery, 48 (2022) 4, Seite 3357-3372
Language:
English
DOI:
10.1007/s00068-022-01941-y
ISSN:
1863-9933;
1863-9941
Origination:
Footnote:
Description:
Abstract Background Circulatory arrest after trauma is a life-threatening situation that mandates urgent action. The aims of this systematic review and meta-analysis on prehospital traumatic cardiac arrest (TCA) were to provide an updated pooled mortality rate for prehospital TCA, to investigate the impact of the time of patient inclusion and the type of prehospital trauma system on TCA mortality rates and neurological outcome, and to investigate which pre- and intra-arrest factors are prognostic for prehospital TCA mortality. Methods This review was conducted in accordance with the PRISMA and CHARMS guidelines. Databases were searched for primary studies published about prehospital TCA patients (1995–2020). Studies were divided into various EMS-system categories. Data were analyzed using MedCalc, Review Manager, Microsoft Excel, and Shinyapps Meta Power Calculator software. Results Thirty-six studies involving 51.722 patients were included. Overall mortality for TCA was 96.2% and a favorable neurological outcome was seen in 43.5% of the survivors. Mortality rates were 97.2% in studies including prehospital deaths and 92.3% in studies excluding prehospital deaths. Favorable neurological outcome rates were 35.8% in studies including prehospital deaths and 49.5% in studies excluding prehospital deaths. Mortality rates were 97.6% if no physician was available at the prehospital scene and 93.9% if a physician was available. Favorable neurological outcome rates were 57.0% if a physician was available on scene and 38.0% if no physician was available. Only non-shockable rhythm was associated with a higher mortality (RR 1.12, p = 0.06). Conclusion Approximately 1 in 20 patients with prehospital TCA will survive; about 40% of survivors have favorable neurological outcome.