Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest
Authors' conclusion
This study found that resuscitative thoracotomy is feasible in a mature, physician-led, urban prehospital system and is associated with improved survival for patients with out-of-hospital TCA, particularly when caused by cardiac tamponade, in situations where other treatment options are limited.
Study context
- Population
- Patients with out-of-hospital traumatic cardiac arrest (TCA) undergoing prehospital resuscitative thoracotomy, London, 1999–2019
- Participants
- 601 patients
- Outcome
- Survival to hospital discharge
Main finding
As reported in the abstract
- Overall survival to hospital discharge (30 patients)
- 5.0%
- Cause of TCA independently associated with survival, aOR
- 21.1 (95% CI 8.1-54.7; P < .001)
- Duration of TCA independently associated with survival, aOR
- 20.9 (95% CI 4.4-100.6, P < .001)
- Absence of need for internal cardiac massage, aOR
- 0.2 (95% CI 0.06-0.5; P = .001)
Observational data: associations, not effects.
Secondary outcomes
Favourable neurological outcome among survivors · discharge
- Favourable neurological outcome (23 survivors)
- 76.6%
Survival by time after TCA
- No survivors beyond 15 minutes of TCA for cardiac tamponade and 5 minutes after exsanguination
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest. JAMA Surg. Published 26 February 2025. doi:10.
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