• LeeMagdalene Hui MinMHM0000-0003-3371-6673Emergency Department, Tan Tock Seng Hospital, Singapore, Singapore., ChiaMichael Yih ChongMYC0000-0002-6952-7439Emergency Department, Tan Tock Seng Hospital, Singapore, Singapore., Stephanie Fook-Chong, Nur Shahidah, Takashi Tagami, Hyun Ho Ryu, Chih-Hao Lin, Sarah Abdul Karim, Supasaowapak Jirapong, RaoH V RajanarsingHVREmergency Medicine Learning Centre, GVK Emergency Management and Research Institute, Secunderabad, Telangana, India., Wenwei Cai, Bernadett Pua Velasco, Nadeem Ullah Khan, Do Ngoc Son, G Y Naroo, Mazen El Sayed, and OngMarcus Eng HockMEH0000-0001-7874-7612Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore.Duke-NUS Medical School, Health Services and Systems Research, Singapore, Singapore..
• Emergency Department, Tan Tock Seng Hospital, Singapore, Singapore.
• Prehosp Emerg Care. 2023 Jan 1; 27 (8): 978986978-986.

ObjectiveLittle is known about survival outcomes after traumatic cardiac arrest in Asia, or the association of Utstein factors with survival after traumatic cardiac arrests. This study aimed to describe the epidemiology and outcomes of traumatic cardiac arrests in Asia, and analyze Utstein factors associated with survival.MethodsTraumatic cardiac arrest patients from 13 countries in the Pan-Asian Resuscitation Outcomes Study registry from 2009 to 2018 were analyzed. Multilevel logistic regression was performed to identify factors associated with the primary outcomes of survival to hospital discharge and favorable neurological outcome (Cerebral Performance Category (CPC) 1-2), and the secondary outcome of return of spontaneous circulation (ROSC).ResultsThere were 207,455 out-of-hospital cardiac arrest cases, of which 13,631 (6.6%) were trauma patients aged 18 years and above with resuscitation attempted and who had survival outcomes reported. The median age was 57 years (interquartile range 39-73), 23.0% received bystander cardiopulmonary resuscitation (CPR), 1750 (12.8%) had ROSC, 461 (3.4%) survived to discharge, and 131 (1.0%) had CPC 1-2. Factors associated with higher rates of survival to discharge and favorable neurological outcome were arrests witnessed by emergency medical services or private ambulances (survival to discharge adjusted odds ratio (aOR) = 2.95, 95% confidence interval (CI) = 1.99-4.38; CPC 1-2 aOR = 2.57, 95% CI = 1.25-5.27), bystander CPR (survival to discharge aOR = 2.16; 95% CI 1.71-2.72; CPC 1-2 aOR = 4.98, 95% CI = 3.27-7.57), and initial shockable rhythm (survival to discharge aOR = 12.00; 95% CI = 6.80-21.17; CPC 1-2 aOR = 33.28, 95% CI = 11.39-97.23) or initial pulseless electrical activity (survival to discharge aOR = 3.98; 95% CI = 2.99-5.30; CPC 1-2 aOR = 5.67, 95% CI = 3.05-10.53) relative to asystole.ConclusionsIn traumatic cardiac arrest, early aggressive resuscitation may not be futile and bystander CPR may improve outcomes.

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