Association of Prehospital Epinephrine Administration With Survival Among Patients With Traumatic Cardiac Arrest Caused By Traffic Collisions

Abstract For traumatic cardiac arrest (TCA), the effect of prehospital epinephrine administration was unclear. The aim of this study was to evaluate the relationship between prehospital epinephrine administration and survival in patients with TCA caused by traffic collisions. We conducted a nationwi...

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Autores principales:	Makoto Aoki, Toshikazu Abe, Kiyohiro Oshima
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2019
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dc88125f73464533862bf5e4b4faead2
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spelling	oai:doaj.org-article:dc88125f73464533862bf5e4b4faead22021-12-02T15:08:32ZAssociation of Prehospital Epinephrine Administration With Survival Among Patients With Traumatic Cardiac Arrest Caused By Traffic Collisions10.1038/s41598-019-46460-w2045-2322https://doaj.org/article/dc88125f73464533862bf5e4b4faead22019-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-019-46460-whttps://doaj.org/toc/2045-2322Abstract For traumatic cardiac arrest (TCA), the effect of prehospital epinephrine administration was unclear. The aim of this study was to evaluate the relationship between prehospital epinephrine administration and survival in patients with TCA caused by traffic collisions. We conducted a nationwide, prospective, population-based observational study involving patients who experienced out-of-hospital cardiac arrest (OHCA) by using the All-Japan Utstein Registry. Blunt trauma patients with TCA who received prehospital epinephrine were compared with those who did not receive prehospital epinephrine. The primary outcome was 1-month survival of patients. The secondary outcome was prehospital return of spontaneous circulation (ROSC). A total of 5,204 patients with TCA were analyzed. Of those, 758 patients (14.6%) received prehospital epinephrine (Epinephrine group), whereas the remaining 4,446 patients (85.4%) did not receive prehospital epinephrine (No epinephrine group). Eleven (1.5%) and 41 (0.9%) patients in the Epinephrine and No epinephrine groups, respectively, survived for 1 month. In addition, 74 (9.8%) and 40 (0.9%) patients achieved prehospital ROSC in the Epinephrine and No epinephrine groups, respectively. In multivariable logistic regression models, prehospital epinephrine administration was not associated with 1-month survival (odds ratio [OR] 1.495, 95% confidence interval [CI] 0.758 to 2.946) and was associated with prehospital ROSC (OR 3.784, 95% CI 2.102 to 6.812). A propensity score-matched analysis showed similar results for 1-month survival (OR 2.363, 95% CI 0.606 to 9,223) and prehospital ROSC (OR 6.870, 95% CI 3.326 to 14.192). Prehospital epinephrine administration in patients with TCA was not associated with 1-month survival, but was beneficial in regard to prehospital ROSC.Makoto AokiToshikazu AbeKiyohiro OshimaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 9, Iss 1, Pp 1-7 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Makoto Aoki Toshikazu Abe Kiyohiro Oshima Association of Prehospital Epinephrine Administration With Survival Among Patients With Traumatic Cardiac Arrest Caused By Traffic Collisions
description	Abstract For traumatic cardiac arrest (TCA), the effect of prehospital epinephrine administration was unclear. The aim of this study was to evaluate the relationship between prehospital epinephrine administration and survival in patients with TCA caused by traffic collisions. We conducted a nationwide, prospective, population-based observational study involving patients who experienced out-of-hospital cardiac arrest (OHCA) by using the All-Japan Utstein Registry. Blunt trauma patients with TCA who received prehospital epinephrine were compared with those who did not receive prehospital epinephrine. The primary outcome was 1-month survival of patients. The secondary outcome was prehospital return of spontaneous circulation (ROSC). A total of 5,204 patients with TCA were analyzed. Of those, 758 patients (14.6%) received prehospital epinephrine (Epinephrine group), whereas the remaining 4,446 patients (85.4%) did not receive prehospital epinephrine (No epinephrine group). Eleven (1.5%) and 41 (0.9%) patients in the Epinephrine and No epinephrine groups, respectively, survived for 1 month. In addition, 74 (9.8%) and 40 (0.9%) patients achieved prehospital ROSC in the Epinephrine and No epinephrine groups, respectively. In multivariable logistic regression models, prehospital epinephrine administration was not associated with 1-month survival (odds ratio [OR] 1.495, 95% confidence interval [CI] 0.758 to 2.946) and was associated with prehospital ROSC (OR 3.784, 95% CI 2.102 to 6.812). A propensity score-matched analysis showed similar results for 1-month survival (OR 2.363, 95% CI 0.606 to 9,223) and prehospital ROSC (OR 6.870, 95% CI 3.326 to 14.192). Prehospital epinephrine administration in patients with TCA was not associated with 1-month survival, but was beneficial in regard to prehospital ROSC.
format	article
author	Makoto Aoki Toshikazu Abe Kiyohiro Oshima
author_facet	Makoto Aoki Toshikazu Abe Kiyohiro Oshima
author_sort	Makoto Aoki
title	Association of Prehospital Epinephrine Administration With Survival Among Patients With Traumatic Cardiac Arrest Caused By Traffic Collisions
title_short	Association of Prehospital Epinephrine Administration With Survival Among Patients With Traumatic Cardiac Arrest Caused By Traffic Collisions
title_full	Association of Prehospital Epinephrine Administration With Survival Among Patients With Traumatic Cardiac Arrest Caused By Traffic Collisions
title_fullStr	Association of Prehospital Epinephrine Administration With Survival Among Patients With Traumatic Cardiac Arrest Caused By Traffic Collisions
title_full_unstemmed	Association of Prehospital Epinephrine Administration With Survival Among Patients With Traumatic Cardiac Arrest Caused By Traffic Collisions
title_sort	association of prehospital epinephrine administration with survival among patients with traumatic cardiac arrest caused by traffic collisions
publisher	Nature Portfolio
publishDate	2019
url	https://doaj.org/article/dc88125f73464533862bf5e4b4faead2
work_keys_str_mv	AT makotoaoki associationofprehospitalepinephrineadministrationwithsurvivalamongpatientswithtraumaticcardiacarrestcausedbytrafficcollisions AT toshikazuabe associationofprehospitalepinephrineadministrationwithsurvivalamongpatientswithtraumaticcardiacarrestcausedbytrafficcollisions AT kiyohirooshima associationofprehospitalepinephrineadministrationwithsurvivalamongpatientswithtraumaticcardiacarrestcausedbytrafficcollisions
_version_	1718388093359226880

Association of Prehospital Epinephrine Administration With Survival Among Patients With Traumatic Cardiac Arrest Caused By Traffic Collisions

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