Hostname: page-component-84b7d79bbc-g78kv Total loading time: 0 Render date: 2024-07-27T16:39:21.027Z Has data issue: false hasContentIssue false

Survival rates for adult trauma patients who require cardiopulmonary resuscitation

Published online by Cambridge University Press:  21 May 2015

Khaled Alanezi
Affiliation:
Trauma Program, Department of Surgery, McMaster University, Hamilton, Ont.
Farhan Alanzi
Affiliation:
Trauma Program, Department of Surgery, McMaster University, Hamilton, Ont.
Samir Faidi
Affiliation:
Trauma Program, Department of Surgery, McMaster University, Hamilton, Ont.
Sheila Sprague
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont.
Margeritta Cadeddu
Affiliation:
Trauma Program, Department of Surgery, McMaster University, Hamilton, Ont.
Frank Baillie
Affiliation:
Trauma Program, Department of Surgery, McMaster University, Hamilton, Ont.
Daniel Bowser
Affiliation:
Trauma Program, Department of Surgery, McMaster University, Hamilton, Ont.
Andy McCallum
Affiliation:
Trauma Program, Department of Surgery, McMaster University, Hamilton, Ont.
Mohit Bhandari*
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont.
*
Clinical Epidemiology and Biostatistics, McMaster University, HSC 2C9, 1200 Main St. W, Hamilton ON L9N 3Z5; 905 525-9140 x22825, fax 905 524-3841, bhandari@sympatico.ca

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objectives:

To determine survival rates in adult trauma patients requiring cardiopulmonary resuscitation (CPR).

Methods:

We used 1992–2002 trauma registry data to identify all adult trauma patients over the age of 16 who required CPR in the pre-hospital setting or within 24 hours of arriving at the hospital. Demographic information, mechanism of injury, injury severity score (ISS), vital signs at the scene and in the hospital, and mortality were obtained from patient charts. Patients were stratified into 2 groups: those with absent vital signs in the field who required prehospital CPR, and those who lost vital signs within 24 hours of arriving at the trauma suite.

Results:

Of 50 eligible patients, 28 (58%) were male and 46 (92%) sustained blunt trauma. Mean age was 44.8 ± 20 years and mean ISS was 38 ± 18. Overall mortality was 96% (48/50), and all patients who required prehospital CPR died. The only 2 survivors were patients who arrived with vital signs and developed pulseless electrical activity while in the trauma suite.

Conclusion:

In this consecutive series of trauma victims with cardiopulmonary arrest there were no survivors among those who lost vital signs and required CPR prior to arriving at the hospital.

Type
Brief Report • Bref Exposé
Copyright
Copyright © Canadian Association of Emergency Physicians 2004

References

1.Kouwenhoven, WB, Jude, JR, Knickerbocker, GG.Closed-chest cardiac massage. JAMA 1960;173:10647.Google Scholar
2.Saklayen, M, Liss, H, Markert, R.In-hospital cardiopulmonary resuscitation: survival in 1 hospital and literature review. Medicine 1995;74:16375.Google Scholar
3.Gray, WA, Capone, RJ, Most, AS.Unsuccessful emergency medical resuscitation: Are continued efforts in the emergency department justified? N Engl J Med 1991;325:13938.Google Scholar
4.Pasquale, MD, Rhodes, M, Cipolle, MD, Hanley, T, Wasser, T.Defining “dead on arrival”: impact on a level I trauma center. J Trauma 1996;41:72630.Google Scholar
5.Rosemurgy, AS, Norris, PA, Olson, SM, Jurst, JM, Albrink, JM.Pre-hospital traumatic cardiac arrest: the cost of futility. J Trauma 1993;35:46873.Google Scholar
6.Stratton, SJ, Brickett, K, Crammer, T.Pre-hospital pulseless, unconscious penetrating trauma victims: field assessment associated with survival. J Trauma 1998;45:96100.Google Scholar
7.Shimazu, S, Shatney, CH.Outcome of trauma patients with no vital signs on hospital admission. J Trauma 1983;23:2136.Google Scholar
8.Kellermann, AL, Hackman, BB.Terminating unsuccessful advanced cardiac life support in the field. Am J Emerg Med 1987; 5;5489.Google Scholar
9.Battistella, FD, Nugent, W, Owings, JT, Anderson, JT.Field triage of the pulseless trauma patient. Arch Surg 1999;134:7425.Google Scholar
10.Fulton, RL, Voigt, WJ, Hilakos, AS.Confusion surrounding the treatments of traumatic cardiac arrest. J Am Coll Surg 1995;181: 20914.Google Scholar
11.Copass, MK, Oreskovich, MR, Bladergroen, MR, Carrico, CJ.Prehospital cardiopulmonary resuscitation of the critically injured patient. Am J Surg 1984;148:206.Google Scholar
12.Durham, LA, Richardson, RJ, Wall, MJ, Pepe, PE, Mattox, KL.Emergency center thoracotomy: impact of pre-hospital resuscitation. J Trauma 1992;32:7759.Google Scholar
13.Mattox, KL, Espada, R, Beall, AC, et al. Performing thoracotomy in the emergency center. JACEP 1974;3:137.Google Scholar
14.Buckberg, GD.A proposed solution to the cardiac controversy. J Thorac Cardiovasc Surg 1979;77:80315.Google Scholar
15.Moore, EE, Moore, JB, Galloway, AC, Eiseman, B.Post-injury thoracotomy in the emergency department: a critical evaluation. Surgery 1979;86:5908.Google Scholar
16.Ivatury, RR, Shah, PM, Ito, K, Ramirez-Schon, G, Suarez, F, Rohman, M.Emergency room thoracotomy for the resuscitation of patients with fatal penetrating injuries to the heart. Ann Thorac Surg 1981;32:37785.Google Scholar