Impact of the 2015 European guidelines for resuscitation on traumatic cardiac arrest outcomes and prehospital management: A French nationwide interrupted time-series analysis

Benhamed, A; Mercier, E; Freyssenge, J; Heidet, M; Gauss, T; Canon, V; Claustre, C; Tazarourte, K; RéAC investigator

doi:10.1016/j.resuscitation.2023.109763

Cardiac arrest & resuscitation

Impact of the 2015 European guidelines for resuscitation on traumatic cardiac arrest outcomes and prehospital management: A French nationwide interrupted time-series analysis

ResuscitationPublished 15 Mar 2023Interrupted time-series analysis

Read the original article ↗PubMed

Cite

Authors' conclusion

Despite the increased frequency of trauma rescue interventions performed by on-scene physicians, no change in patient-centred outcomes was associated with the publication of the 2015 ERC guidelines in France.

Study context

Population: Adults (≥18 years) with traumatic cardiac arrest treated by physician-staffed ambulances, French nationwide cardiac arrest registry
Participants: 4,980 adults

Exposure: Post-publication vs pre-publication of the 2015 European Resuscitation Council (ERC) guidelines
Post-publicationn = 2,739
Pre-publicationn = 2,145reference
Outcome: Prehospital ROSC, survival, good neurological outcome, organ donation

Methodological detailsnationwide registry, adjusted

Nationwide registry
Adjusted

Main finding

As reported in the abstract

Prehospital ROSC

P = 0.07

Pre-publication22.4%

Post-publication20.2%

Survival

P = 0.87

Pre-publication1.4%

Post-publication1.4%

Good neurological outcome

P = 0.93

Pre-publication71.4%

Post-publication66.7%

Organ donation

P = 0.50

Pre-publication1.6%

Post-publication1.3%

Change in adjusted temporal trend for ROSC (nonsignificant), aOR [95% CI]: 0.88 [0.77; 1.00]
Change in adjusted temporal trend for survival (nonsignificant), aOR [95% CI]: 1.34 [0.83;2.17]
Change in adjusted temporal trend for good neurological outcome (nonsignificant), aOR [95% CI]: 1.57 [0.82;3.05]
Change in adjusted temporal trend for organ donation (nonsignificant), aOR [95% CI]: 1.06 [0.71;1.60]

Observational data: associations, not effects.

Further findings

Prehospital interventions

Intraosseous catheters

P < 0.001

Pre-publication13.0%

Post-publication19.2%

External haemorrhage control

P < 0.001

Pre-publication23.9%

Post-publication64.8%

Bilateral chest decompression

P = 0.009

Pre-publication13.7%

Post-publication16.5%

Packed red cell transfusion

P < 0.001

Pre-publication2.7%

Post-publication6.5%

Original publication

Impact of the 2015 European guidelines for resuscitation on traumatic cardiac arrest outcomes and prehospital management: A French nationwide interrupted time-series analysis. Resuscitation. Published 15 March 2023. doi:10.1016/j.resuscitation.2023.109763

Read the original article ↗

Composed by AI from the published abstract and checked against it. How Briefs are made →