title: Outcomes of patients with trauma and intraoperative cardiac arrest.
abstract: BACKGROUND
  Although the occurrence of intraoperative cardiac arrest is rare, it is a severe adverse event with a high mortality rate. Trauma patients have additional causes for intraoperative arrest, and we hypothesised that the survival of trauma patients who experienced intraoperative cardiac arrest would be worse than nontrauma patients who experienced intraoperative cardiac arrest.
  
  
  OBJECTIVE
  The aim of the present study was to compare the outcomes of trauma and nontrauma patients after intraoperative cardiac arrest.
  
  
  METHODS
  In a tertiary university hospital and trauma centre, the intraoperative cardiac arrest cases were evaluated from January 2007 to December 2009, excluding patients submitted to cardiac surgery. Data were prospectively collected using the Utstein-style. Outcomes among the patients with trauma were compared to the patients without trauma.
  
  
  RESULTS
  We collected data from 81 consecutive intraoperative cardiac arrest cases: 32 with trauma and 49 without trauma. Patients in the trauma group were younger than the patients in the nontrauma group (44±23 vs. 63±17, p<0.001). Hypovolaemia (63% vs. 35%, p=0.022) and metabolic/hydroelectrolytic disturbances (41% vs. 2%, p<0.001) were more likely to cause the cardiac arrest in the trauma group. The first documented arrest rhythm did not differ between the groups, and pulseless electrical activity was the most prevalent rhythm (66% vs. 53%, p=0.698). The return of spontaneous circulation (47% vs. 63%, p=0.146) and survival to discharge with favourable neurological outcome (16% vs. 14%, p=0.869) did not differ between the two groups.
  
  
  CONCLUSIONS
  The outcomes did not differ between patients with trauma and nontrauma intraoperative cardiac arrest.
authors.affiliation: Discipline of Anesthesiology, Clinical Hospital, University of Sao Paulo Medical School, 255 Doctor Eneas de Carvalho Aguiar Avenue, Cerqueira Cesar, Sao Paulo, SP, Brazil.
authors.forename: Flavia O
authors.initials: FO
authors.lastname: Toledo
authors.forename: Maria M
authors.initials: MM
authors.lastname: Gonzalez
authors.forename: Ilana
authors.initials: I
authors.lastname: Sebbag
authors.forename: Rolison G B
authors.initials: RG
authors.lastname: Lelis
authors.forename: Gustavo F
authors.initials: GF
authors.lastname: Aranha
authors.forename: Sergio
authors.initials: S
authors.lastname: Timerman
authors.forename: Maria J C
authors.initials: MJ
authors.lastname: Carmona
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006323:Heart Arrest / Q000150:complications* / Q000209:etiology / Q000401:mortality; D006785:Hospitals, University; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D014947:Wounds and Injuries / Q000150:complications* / Q000401:mortality / Q000601:surgery*