title: Cardiopulmonary resuscitation of out-of-hospital traumatic cardiac arrest in Qatar: A nationwide population-based study.
abstract: BACKGROUND
  Traumatic cardiac arrest studies have reported improved survival rates recently, ranging from 1.7-7.5%. This population-based nationwide study aims to describe the epidemiology, interventions and outcomes, and determine predictors of survival from out-of-hospital traumatic cardiac arrest (OHTCA) in Qatar.
  
  
  METHODS
  An observational retrospective population-based study was conducted on OHTCA patients in Qatar, from January 2010 to December 2015. Traumatic cardiac arrest was redefined to include out-of-hospital traumatic cardiac arrest (OHTCA) and in-hospital traumatic cardiac arrest (IHTCA).
  
  
  RESULTS
  A total of 410 OHTCA patients were included in the 6-year study period. The mean annual crude incidence rate of OHTCA was 4.0 per 100,000 population, in Qatar. OHTCA mostly occurred in males with a median age of 33. There was a preponderance of blunt injuries (94.3%) and head injuries (66.3%). Overall, the survival rate was 2.4%. Shockable rhythm, prehospital external hemorrhage control, in-hospital blood transfusion, and surgery were associated with higher odds of survival. Adrenaline (Epinephrine) lowered the odds of survival.
  
  
  CONCLUSIONS
  The incidence of OHTCA was less than expected, with a low rate of survival. Thoracotomy was not associated with improved survival while Adrenaline administration lowered survival in OHTCA patients with majority blunt injuries. Interventions to enable early prehospital control of hemorrhage, blood transfusion, thoracostomy and surgery improved survival.
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE-118 83 Stockholm, Sweden; Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. Electronic address: furqan.irfan@gmail.com.
authors.forename: Furqan B
authors.initials: FB
authors.lastname: Irfan
authors.affiliation: Trauma Surgery Section, Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. Electronic address: RConsunji@hamad.qa.
authors.forename: Rafael
authors.initials: R
authors.lastname: Consunji
authors.affiliation: Trauma Surgery Section, Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. Electronic address: aymanco65@yahoo.com.
authors.forename: Ayman
authors.initials: A
authors.lastname: El-Menyar
authors.affiliation: Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. Electronic address: pooja_george3514@yahoo.com.
authors.forename: Pooja
authors.initials: P
authors.lastname: George
authors.affiliation: Trauma Surgery Section, Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. Electronic address: rperaltamd@gmail.com.
authors.forename: Ruben
authors.initials: R
authors.lastname: Peralta
authors.affiliation: Trauma Surgery Section, Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. Electronic address: Halthani@hamad.qa.
authors.forename: Hassan
authors.initials: H
authors.lastname: Al-Thani
authors.affiliation: Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. Electronic address: sthomas88@hamad.qa.
authors.forename: Stephen Hodges
authors.initials: SH
authors.lastname: Thomas
authors.affiliation: Hamad Medical Corporation Ambulance Service, Medical City, Doha, Qatar; School of Health and Social Work, Paramedic Division, University of Hertfordshire, Hatfield AL10 9AB, HERTS, UK. Electronic address: GAlinier@hamad.qa.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Alinier
authors.affiliation: Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar. Electronic address: AShuaib@hamad.qa.
authors.forename: Ashfaq
authors.initials: A
authors.lastname: Shuaib
authors.affiliation: Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar. Electronic address: jalsuwaidi@hotmail.com.
authors.forename: Jassim
authors.initials: J
authors.lastname: Al-Suwaidi
authors.affiliation: Cardiology Research, Heart Hospital, Hamad Medical Corporation, Doha, Qatar. Electronic address: rsingh@hamad.qa.
authors.forename: Rajvir
authors.initials: R
authors.lastname: Singh
authors.affiliation: Helsinki University, Department of Emergency Medicine and Services, Helsinki University Hospital, Haartmaninkatu 4, 00029 HUS, Finland. Electronic address: maaret.castren@hus.fi.
authors.forename: Maaret
authors.initials: M
authors.lastname: Castren
authors.affiliation: The Alfred Hospital, Emergency and Trauma Centre, School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC 3004, Australia. Electronic address: Peter.Cameron@monash.edu.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cameron
authors.affiliation: Department of Medicine Solna, 171 00, Karolinska Institutet, Sweden. Electronic address: Therese.Djarv@ki.se.
authors.forename: Therese
authors.initials: T
authors.lastname: Djarv
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy*; D011159:Population Surveillance / Q000379:methods; D011780:Qatar / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends
keywords: Cardiopulmonary resuscitation; Prehospital; Trauma; Traumatic cardiac arrest