Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in Qatar

<h3>Background</h3><p dir="ltr">Cardiac arrests in admitted hospital patients with trauma have not been described in the literature. We defined “in-hospital cardiac arrest of a trauma” (IHCAT) patient as “cessation of circulatory activity in a trauma patient confirmed by...

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Main Author: Furqan B. Irfan (13359828) (author)
Other Authors: Rafael I. G. D. J. Consunji (21385553) (author), Ruben Peralta (768896) (author), Ayman El-Menyar (440103) (author), Landric B. Dsouza (21385556) (author), Jassim M. Al-Suwaidi (21385559) (author), Rajvir Singh (315457) (author), Maaret Castrén (3559490) (author), Therese Djärv (9582044) (author), Guillaume Alinier (6952004) (author)
Published: 2022
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author Furqan B. Irfan (13359828)
author2 Rafael I. G. D. J. Consunji (21385553)
Ruben Peralta (768896)
Ayman El-Menyar (440103)
Landric B. Dsouza (21385556)
Jassim M. Al-Suwaidi (21385559)
Rajvir Singh (315457)
Maaret Castrén (3559490)
Therese Djärv (9582044)
Guillaume Alinier (6952004)
author2_role author
author
author
author
author
author
author
author
author
author_facet Furqan B. Irfan (13359828)
Rafael I. G. D. J. Consunji (21385553)
Ruben Peralta (768896)
Ayman El-Menyar (440103)
Landric B. Dsouza (21385556)
Jassim M. Al-Suwaidi (21385559)
Rajvir Singh (315457)
Maaret Castrén (3559490)
Therese Djärv (9582044)
Guillaume Alinier (6952004)
author_role author
dc.creator.none.fl_str_mv Furqan B. Irfan (13359828)
Rafael I. G. D. J. Consunji (21385553)
Ruben Peralta (768896)
Ayman El-Menyar (440103)
Landric B. Dsouza (21385556)
Jassim M. Al-Suwaidi (21385559)
Rajvir Singh (315457)
Maaret Castrén (3559490)
Therese Djärv (9582044)
Guillaume Alinier (6952004)
dc.date.none.fl_str_mv 2022-09-16T09:00:00Z
dc.identifier.none.fl_str_mv 10.1186/s12245-022-00454-0
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Comparison_of_in-hospital_and_out-of-hospital_cardiac_arrest_of_trauma_patients_in_Qatar/29098490
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Health sciences
Epidemiology
In-hospital cardiac arrest of trauma patient
Qatar
Patient outcome
Mortality
Survival
Trauma
dc.title.none.fl_str_mv Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in Qatar
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Cardiac arrests in admitted hospital patients with trauma have not been described in the literature. We defined “in-hospital cardiac arrest of a trauma” (IHCAT) patient as “cessation of circulatory activity in a trauma patient confirmed by the absence of signs of circulation or abnormal cardiac arrest rhythm inside a hospital setting, which was not cardiac re-arrest.” This study aimed to compare epidemiology, clinical presentation, and outcomes between in- and out-of-hospital arrest resuscitations in trauma patients in Qatar. It was conducted as a retrospective cohort study including IHCAT and out-of-hospital trauma cardiac arrest (OHTCA) patients from January 2010 to December 2015 utilizing data from the national trauma registry, the out-of-hospital cardiac arrest registry, and the national ambulance service database.</p><h3>Results</h3><p dir="ltr">There were 716 traumatic cardiac arrest patients in Qatar from 2010 to 2015. A total of 410 OHTCA and 199 IHCAT patients were included for analysis. The mean annual crude incidence of IHCAT was 2.0 per 100,000 population compared to 4.0 per 100,000 population for OHTCA. The univariate comparative analysis between IHCAT and OHTCA patients showed a significant difference between ethnicities (<i>p</i>=0.04). With the exception of head injury, IHCAT had a significantly higher proportion of localization of injuries to anatomical regions compared to OHTCA; spinal injury (OR 3.5, 95% CI 1.5–8.3, <i>p</i><0.004); chest injury (OR 2.62, 95% CI 1.62–4.19, <i>p</i><0.00), and abdominal injury (OR 2.0, 95% CI 1.0–3.8, <i>p</i><0.037). IHCAT patients had significantly higher hypovolemia (OR 1.66, 95% CI 1.18–2.35, <i>p</i>=0.004), higher mean Glasgow Coma Scale (GCS) score (OR 1.4, 95% CI 1.3–1.6, <i>p</i><0.00), and a greater proportion of initial shockable rhythm (OR 3.51, 95% CI 1.6–7.7, <i>p</i>=0.002) and cardiac re-arrest (OR 6.0, 95% CI 3.3–10.8, <i>p</i>=<0.00) compared to OHTCA patients. Survival to hospital discharge was greater for IHCAT patients compared to OHTCA patients (OR 6.3, 95% CI 1.3–31.2, <i>p</i>=0.005). Multivariable analysis for comparison after adjustment for age and gender showed that IHCAT was associated with higher odds of spinal injury, abdominal injury, higher pre-hospital GCS, higher occurrence of cardiac re-arrest, and better survival than for OHTCA patients. IHCAT patients had a greater proportion of anatomically localized injuries indicating solitary injuries compared to greater polytrauma in OHTCA. In contrast, OHTCA patients had a higher proportion of diffuse blunt non-localizable polytrauma injuries that were severe enough to cause immediate or earlier onset of cardiac arrest.</p><h3>Conclusion</h3><p dir="ltr">In traumatic cardiac arrest patients, IHCAT was less common than OHTCA and might be related to a greater proportion of solitary localized anatomical blunt injuries (head/abdomen/chest/spine). In contrast, OHTCA patients were associated with diffuse blunt non-localizable polytrauma injuries with increased severity leading to immediate cardiac arrest. IHCAT was associated with a higher mean GCS score and a higher rate of initial shockable rhythm and cardiac re-arrest, and improved survival rates.</p><h2>Other Information</h2><p dir="ltr">Published in: International Journal of Emergency Medicine<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12245-022-00454-0" target="_blank">https://dx.doi.org/10.1186/s12245-022-00454-0</a></p>
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spelling Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in QatarFurqan B. Irfan (13359828)Rafael I. G. D. J. Consunji (21385553)Ruben Peralta (768896)Ayman El-Menyar (440103)Landric B. Dsouza (21385556)Jassim M. Al-Suwaidi (21385559)Rajvir Singh (315457)Maaret Castrén (3559490)Therese Djärv (9582044)Guillaume Alinier (6952004)Biomedical and clinical sciencesClinical sciencesHealth sciencesEpidemiologyIn-hospital cardiac arrest of trauma patientQatarPatient outcomeMortalitySurvivalTrauma<h3>Background</h3><p dir="ltr">Cardiac arrests in admitted hospital patients with trauma have not been described in the literature. We defined “in-hospital cardiac arrest of a trauma” (IHCAT) patient as “cessation of circulatory activity in a trauma patient confirmed by the absence of signs of circulation or abnormal cardiac arrest rhythm inside a hospital setting, which was not cardiac re-arrest.” This study aimed to compare epidemiology, clinical presentation, and outcomes between in- and out-of-hospital arrest resuscitations in trauma patients in Qatar. It was conducted as a retrospective cohort study including IHCAT and out-of-hospital trauma cardiac arrest (OHTCA) patients from January 2010 to December 2015 utilizing data from the national trauma registry, the out-of-hospital cardiac arrest registry, and the national ambulance service database.</p><h3>Results</h3><p dir="ltr">There were 716 traumatic cardiac arrest patients in Qatar from 2010 to 2015. A total of 410 OHTCA and 199 IHCAT patients were included for analysis. The mean annual crude incidence of IHCAT was 2.0 per 100,000 population compared to 4.0 per 100,000 population for OHTCA. The univariate comparative analysis between IHCAT and OHTCA patients showed a significant difference between ethnicities (<i>p</i>=0.04). With the exception of head injury, IHCAT had a significantly higher proportion of localization of injuries to anatomical regions compared to OHTCA; spinal injury (OR 3.5, 95% CI 1.5–8.3, <i>p</i><0.004); chest injury (OR 2.62, 95% CI 1.62–4.19, <i>p</i><0.00), and abdominal injury (OR 2.0, 95% CI 1.0–3.8, <i>p</i><0.037). IHCAT patients had significantly higher hypovolemia (OR 1.66, 95% CI 1.18–2.35, <i>p</i>=0.004), higher mean Glasgow Coma Scale (GCS) score (OR 1.4, 95% CI 1.3–1.6, <i>p</i><0.00), and a greater proportion of initial shockable rhythm (OR 3.51, 95% CI 1.6–7.7, <i>p</i>=0.002) and cardiac re-arrest (OR 6.0, 95% CI 3.3–10.8, <i>p</i>=<0.00) compared to OHTCA patients. Survival to hospital discharge was greater for IHCAT patients compared to OHTCA patients (OR 6.3, 95% CI 1.3–31.2, <i>p</i>=0.005). Multivariable analysis for comparison after adjustment for age and gender showed that IHCAT was associated with higher odds of spinal injury, abdominal injury, higher pre-hospital GCS, higher occurrence of cardiac re-arrest, and better survival than for OHTCA patients. IHCAT patients had a greater proportion of anatomically localized injuries indicating solitary injuries compared to greater polytrauma in OHTCA. In contrast, OHTCA patients had a higher proportion of diffuse blunt non-localizable polytrauma injuries that were severe enough to cause immediate or earlier onset of cardiac arrest.</p><h3>Conclusion</h3><p dir="ltr">In traumatic cardiac arrest patients, IHCAT was less common than OHTCA and might be related to a greater proportion of solitary localized anatomical blunt injuries (head/abdomen/chest/spine). In contrast, OHTCA patients were associated with diffuse blunt non-localizable polytrauma injuries with increased severity leading to immediate cardiac arrest. IHCAT was associated with a higher mean GCS score and a higher rate of initial shockable rhythm and cardiac re-arrest, and improved survival rates.</p><h2>Other Information</h2><p dir="ltr">Published in: International Journal of Emergency Medicine<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12245-022-00454-0" target="_blank">https://dx.doi.org/10.1186/s12245-022-00454-0</a></p>2022-09-16T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1186/s12245-022-00454-0https://figshare.com/articles/journal_contribution/Comparison_of_in-hospital_and_out-of-hospital_cardiac_arrest_of_trauma_patients_in_Qatar/29098490CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/290984902022-09-16T09:00:00Z
spellingShingle Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in Qatar
Furqan B. Irfan (13359828)
Biomedical and clinical sciences
Clinical sciences
Health sciences
Epidemiology
In-hospital cardiac arrest of trauma patient
Qatar
Patient outcome
Mortality
Survival
Trauma
status_str publishedVersion
title Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in Qatar
title_full Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in Qatar
title_fullStr Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in Qatar
title_full_unstemmed Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in Qatar
title_short Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in Qatar
title_sort Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in Qatar
topic Biomedical and clinical sciences
Clinical sciences
Health sciences
Epidemiology
In-hospital cardiac arrest of trauma patient
Qatar
Patient outcome
Mortality
Survival
Trauma