Table 3.
Characteristics of patients with prehospital traumatic cardiac arrest in each phase
| Characteristicsa | Pre-EMS phase (n = 426) | EMS phase (n = 113) | HEMS phase (n = 168) | p-valueb |
|---|---|---|---|---|
| Age, median (IQR), year | 61 (40, 74) | 69 (53, 81) | 72.5 (60, 82) | < 0.001 |
| Sex, n (%) | 0.007 | |||
| Male | 229 (82.1) | 57 (72.2) | 81 (68.6) | |
| Female | 50 (17.9) | 22 (27.8) | 37 (31.4) | |
| Type of injury, n (%) | 0.25 | |||
| Blunt | 241 (88.9) | 74 (87.1) | 111 (94.1) | |
| Penetrating | 18 (6.6) | 9 (9.6) | 5 (4.2) | |
| Others | 12 (4.4) | 2 (2.1) | 2 (1.7) | |
| Time, median (IQR), minute | ||||
| HEMS call ~ HEMS contacts patients | 22 (18, 28) | 22 (17, 28) | 22 (17, 28) | 0.90 |
| HEMS stay at scene | 21 (16, 26) | 22.5 (17, 29) | 23 (18, 29) | 0.03 |
| HEMS call ~ hospital arrival | 52 (44, 64) | 55 (47, 66) | 53 (45, 70) | 0.26 |
| AIS, median (IQR) | ||||
| Head (n = 281) | 2 (0, 4) | 1 (0, 4) | 3 (0, 5) | 0.21 |
| Face (n = 279) | 0 (0, 0) | 0 (0, 0) | 0 (0, 0) | 0.88 |
| Chest (n = 284) | 4 (0, 5) | 3 (0, 3.5) | 4 (1.5, 5) | 0.02 |
| Abdomen (n = 290) | 0 (0, 1) | 0 (0, 0) | 2 (0, 3) | < 0.001 |
| Limbs (n = 288) | 0 (0, 3) | 1 (0, 3) | 1 (0, 3) | 0.11 |
| Skin (n = 282) | 0 (0, 1) | 0 (0, 1) | 0 (0, 1) | 0.09 |
| Interventions, n (%) | ||||
| EMS crew | ||||
| Intravenous route | 91/401 (22.7) | 20/109 (18.3) | 16/165 (9.7) | 0.002 |
| Epinephrine | 54/401 (13.5) | 10/107 (9.3) | 4/164 (2.4) | < 0.001 |
| Endotracheal intubation | 18/399 (4.5) | 4/109 (3.7) | 1/165 (0.6) | 0.07 |
| HEMS crew | ||||
| Chest drainage | 76/426 (17.8) | 18/113 (15.9) | 47/168 (28.0) | 0.01 |
| Vasopressor agentsc | 363/426 (85.2) | 95/115 (84.1) | 69/168 (41.1) | < 0.001 |
| Bicarbonate | 6/426 (1.4) | 1/113 (0.9) | 1/168 (0.6) | 0.68 |
| Hemostatic agentsd | 25/426 (5.9) | 19/113 (15.9) | 19/168 (11.3) | 0.001 |
| Sedation | 12/426 (2.8) | 4/113 (3.5) | 50/168 (29.8) | < 0.001 |
| Muscle relaxant | 6/426 (1.4) | 2/113 (1.8) | 31/168 (18.5) | < 0.001 |
| Opioids | 3/426 (0.6) | 0/113 (0.0) | 4/168 (2.4) | 0.09 |
| Endotracheal intubation | 333/423 (78.7) | 90/113 (79.6) | 114/167 (68.3) | 0.02 |
| Resuscitative thoracotomy | 153/426 (35.9) | 36/113 (31.9) | 23/168 (13.7) | < 0.001 |
| Blood transfusion | 7/426 (1.6) | 1/113 (0.9) | 4/168 (2.4) | 0.63 |
| Outcome, n (%) | ||||
| ROSC | 111/426 (26.1) | 33/113 (29.2) | 8/168 (4.8) | < 0.001 |
| 28-day survival rate | 30/414 (7.2) | 12/109 (11.0) | 2/168 (1.2) | 0.002 |
| 28-day CPC 1 or 2e | 10/410 (2.4) | 7/107 (6.5) | 1/167 (0.6) | 0.01 |
| 28-day CPC 1 or 2 rate | 10/30 (33.3) | 7/12 (58.3) | 1/2 (50.0) | 0.35 |
| 28-day CPC | 0.01 | |||
| CPC 1 | 7/411 (1.7) | 7/107 (6.5) | 0/167 (0.0) | |
| CPC 2 | 3/411 (0.7) | 0/107 (0.0) | 1/167 (0.6) | |
| CPC 3 | 6/411 (1.5) | 2/107 (1.9) | 0/167 (0.0) | |
| CPC 4 | 9/411 (2.2) | 2/107 (1.9) | 1/167 (0.6) | |
| CPC 5 | 386/411 (93.7) | 96/107 (89.8) | 165/167 (98.8) | |
AIS abbreviated injury scale, CPC cerebral performance category, EMS emergency medical service, HEMS helicopter emergency medical service, IQR interquartile range, ROSC return of spontaneous circulation
aCategorical variables are presented as counts and percentages (%), whereas numerical variables are presented as medians and interquartile ranges (IQRs)
bThe results were statistically significant based on p < 0.05
cVasopressor agents included epinephrine, norepinephrine, phenylephrine, and dopamine
dHemostatic agents included tranexamic acid and carbazochrome sodium sulfonate