Impact of cardiopulmonary resuscitation time on the effectiveness of emergency department thoracotomy after blunt trauma

Ryo Yamamoto, Masaru Suzuki, Rakuhei Nakama, Kenichi Kase, Kazuhiko Sekine, Tomohiro Kurihara, Junichi Sasaki

Research output: Contribution to journalArticle

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Abstract

Purpose: Debate remains about the threshold cardiopulmonary resuscitation (CPR) duration associated with futile emergency department thoracotomy (EDT). To validate the CPR duration associated with favorable outcomes, we investigated the relationship between CPR duration and return of spontaneous circulation (ROSC) after EDT in blunt trauma. Methods: A retrospective observational study was conducted at three tertiary centers over the last 7 years. We included bluntly injured adults who were pulseless and required EDT at presentation, but excluded those with devastating head injuries. After multivariate logistic regression identified the CRP duration as an independent predictor of ROSC, receiver operating characteristic curves were used to determine the threshold CPR duration. Patient data were divided into short- and long-duration CPR groups based on this threshold, and we developed a propensity score to estimate assignment to the short-duration CPR group. The ROSC rates were compared between groups after matching. Results: Forty patients were eligible for this study and ROSC was obtained in 12. The CPR duration was independently associated with the achievement of ROSC [odds ratio 1.18; 95% confidence interval (CI) 1.01–1.37, P = 0.04], and the threshold CPR duration was 17 min. Among the 14 patients with a short CPR duration, 13 matched with the patients with a long CPR duration, and a short CPR duration was significantly associated with higher rates of ROSC (odds ratio 8.80; 95% CI 1.35–57.43, P = 0.02). Conclusions: A CPR duration < 17 min is independently associated with higher ROSC rates in patients suffering blunt trauma.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalEuropean Journal of Trauma and Emergency Surgery
DOIs
Publication statusAccepted/In press - 2018 May 31

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Cardiopulmonary Resuscitation
Thoracotomy
Hospital Emergency Service
Wounds and Injuries
Odds Ratio
Confidence Intervals
Propensity Score
Craniocerebral Trauma
ROC Curve
Observational Studies
Retrospective Studies
Logistic Models

Keywords

  • Blunt trauma
  • Cardiopulmonary resuscitation
  • Emergency department thoracotomy
  • Traumatic cardiopulmonary arrest

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Orthopedics and Sports Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Impact of cardiopulmonary resuscitation time on the effectiveness of emergency department thoracotomy after blunt trauma. / Yamamoto, Ryo; Suzuki, Masaru; Nakama, Rakuhei; Kase, Kenichi; Sekine, Kazuhiko; Kurihara, Tomohiro; Sasaki, Junichi.

In: European Journal of Trauma and Emergency Surgery, 31.05.2018, p. 1-8.

Research output: Contribution to journalArticle

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