CJEM. 2026 Jul 27. doi: 10.1007/s43678-026-01247-7. Online ahead of print.
ABSTRACT
OBJECTIVES: Historically, traumatic cardiac arrest studies have described poor survival rates and argued that resuscitation is futile. However, recent reports have demonstrated that survival rates may be higher than previously appreciated. Our objectives were to determine survival rates in traumatic cardiac arrest patients and assess for factors associated with survival to hospital discharge.
METHODS: We conducted a registry review study of adult traumatic cardiac arrest patients (≥ 17 years old) in Nova Scotia over a 16-year period (2007-2023). Data were collected from the paramedic electronic Patient Care Record and the Nova Scotia Trauma Registry. The primary outcome was survival to hospital discharge. We compared characteristics between survivors and non-survivors and assessed for predictors of survival. Descriptive statistics, t-tests, chi-square analysis, and multivariable logistic regression models were used.
RESULTS: A total of 1042 patients were included in the analysis. Ages ranged from 17 to 96 years (mean 50.03 ± 19.2), and 80.7% were male. Most injuries were blunt trauma (71.7%, 747/1042). The overall survival rate was 1.9% (20/1042). Compared to non-survivors, patients who survived to hospital discharge had lower mean Injury Severity Score (17.8 ± 11.1 vs. 34.4 ± 21.3, p < 0.001). On multivariate analysis, survival to discharge was associated with critical care transport (OR 27.16, 95%CI 7.32-103.86) and direct transport to final facility (OR 4.10, 95%CI 1.37-11.80), while increasing Injury Severity Score (OR 0.93, 95%CI 0.88-0.97) was associated with mortality.
CONCLUSIONS: Survival to hospital discharge was observed in 1.9% of traumatic cardiac arrest patients. Critical care transport and direct transport to the final facility were associated with patient survival. The identified predictors of survival may help inform prehospital triage and resuscitation strategies for patients experiencing traumatic cardiac arrest.
PMID:42507326 | DOI:10.1007/s43678-026-01247-7
