title: Long-term prognosis after out-of-hospital resuscitation of cardiac arrest in trauma patients: prehospital trauma-associated cardiac arrest.
abstract: BACKGROUND
  Although prehospital cardiac arrest (CA) remains associated with poor long-term outcome, recent studies show an improvement in the survival rate after prehospital trauma associated CA (TCA). However, data on the long-term neurological outcome of TCA, particularly from physician-staffed Emergency Medical Service (EMS), are scarce, and results reported have been inconsistent. The objective of this pilot study was to evaluate the long-term outcome of patients admitted to several trauma centres after a TCA.
  
  
  METHODS
  This study is a retrospective database review of all patients from a multicentre prospective registry that experienced a TCA and had undergone successful cardiopulmonary resuscitation (CPR) prior their admission at the trauma centre. The primary end point was neurological outcome at 6 months among patients who survived to hospital discharge.
  
  
  RESULTS
  88 victims of TCA underwent successful CPR and were admitted to the hospital, 90% of whom were victims of blunt trauma. Of these 88 patients, 10 patients (11%; CI 95% 6% to 19%) survived to discharge: on discharge, 9 patients displayed a GCS of 15 and Cerebral Performance Categories (CPC) 1-2 and one patient had a GCS 7 and CPC of 3. Hypoxia was the most frequent cause of CA among survivors. 6-month follow-up was achieved for 9 patients of the 10 surviving patients. The 9 patients with a good outcome on hospital discharge had a CPC of 1 or 2 6 months post discharge. All returned to their premorbid family and social settings.
  
  
  CONCLUSIONS
  Among patients admitted to hospital after successful CPR from TCA, hypoxia as the likely aetiology of arrest carried a more favourable prognosis. Most of the patients successfully resuscitated from TCA and surviving to hospital discharge had a good neurological outcome, suggesting that prehospital resuscitation may not be futile.
authors: Emergency Medical Service Department, Beaujon University Hospital, Clichy, France.
authors: François-Xavier
authors: FX
authors: Duchateau
authors: Department of Anaesthesiology and Intensive Care, Hôpitaux Universitaires Paris Sud, Université Paris Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
authors: Sophie
authors: S
authors: Hamada
authors: Department of Anaesthesiology and Intensive Care, Pitié Salpétrière University Hospital, Paris, France.
authors: Mathieu
authors: M
authors: Raux
authors: Emergency Medical Service Department, Beaujon University Hospital, Clichy, France.
authors: Matthieu
authors: M
authors: Gay
authors: Department of Anaesthesiology and Critical Care, Beaujon University Hospital, Clichy, France.
authors: Jean
authors: J
authors: Mantz
authors: Department of Anaesthesiology and Critical Care, Beaujon University Hospital, Clichy, France.|Université Denis Diderot-Paris VII, Paris, France.
authors: Catherine
authors: C
authors: Paugam Burtz
authors: Department of Anaesthesiology and Critical Care, Beaujon University Hospital, Clichy, France.
authors: Tobias
authors: T
authors: Gauss
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate; D014947:Wounds and Injuries / Q000150:complications*
keywords: Trauma, majot trauma management; cardiac arrest; pre-hospital