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Trends in traumatic out-of-hospital cardiac arrest in Perth, Western Australia from 1997 to 2014

2015; Elsevier BV; Volume: 98; Linguagem: Inglês

10.1016/j.resuscitation.2015.10.015

1873-1570

Ben Beck, Hideo Tohira, Janet Bray, Lahn Straney, Elizabeth Brown, Madoka Inoue, Teresa A. Williams, Nicole McKenzie, Antonio Celenza, Paul Bailey, Judith Finn,

Trauma and Emergency Care Studies

Aim This study aims to describe and compare traumatic and medical out-of-hospital cardiac arrest (OHCA) occurring in Perth, Western Australia, between 1997 and 2014. Methods The St John Ambulance Western Australia (SJA-WA) OHCA Database was used to identify all adult (≥16 years) cases. We calculated annual crude and age-sex standardised incidence rates (ASIRs) for traumatic and medical OHCA and investigated trends over time. Results Over the study period, SJA-WA attended 1,354 traumatic OHCA and 16,076 medical OHCA cases. The mean annual crude incidence rate of traumatic OHCA in adults attended by SJA-WA was 6.0 per 100,000 (73.9 per 100,000 for medical cases), with the majority resulting from motor vehicle collisions (56.7%). We noted no change to either incidence or mechanism of injury over the study period (p > 0.05). Compared to medical OHCA, traumatic OHCA cases were less likely to receive bystander cardiopulmonary resuscitation (CPR) (20.4% vs. 24.5%, p = 0.001) or have resuscitation commenced by paramedics (38.9% vs. 44.8%, p < 0.001). However, rates of bystander CPR and resuscitation commenced by paramedics increased significantly over time in traumatic OHCA (p < 0.001). In cases where resuscitation was commenced by paramedics there was no difference in the proportion who died at the scene (37.2% traumatic vs. 34.3% medical, p = 0.17), however, fewer traumatic OHCAs survived to hospital discharge (1.7% vs. 8.7%, p < 0.001). Conclusions Despite temporal increases in rates of bystander CPR and paramedic resuscitation, traumatic OHCA survival remains poor with only nine patients surviving from traumatic OHCA over the 18-year period.