Da. Margolin et al., RESPONSE AFTER OUT-OF-HOSPITAL CARDIAC-ARREST IN THE TRAUMA PATIENT SHOULD DETERMINE AEROMEDICAL TRANSPORT TO A TRAUMA CENTER, The journal of trauma, injury, infection, and critical care, 41(4), 1996, pp. 721-725
Objective: To evaluate whether aeromedical transport of trauma patient
s who sustain an out-of-hospital cardiac arrest (OHCA) is justified, D
esign: Retrospective chart review, Methods: We reviewed the outcome of
67 consecutive patients after OHCA with initial resuscitation who wer
e transported to a Level I trauma center, Statistical analysis was use
d to develop a predictive model for survival. Results: The overall sur
vival was 19%, One of 28 patients with a second OHCA survived (p = 0.0
05), Logistic regression analysis demonstrated that the Revised Trauma
Score at trauma center arrival (1.0 +/- 0.25, nonsurvivors vs, 5.15 /- 0.86, survivors, p = 0.0001), Injury Severity Score (34.9 +/- 2.9,
nonsurvivors vs, 21.3 +/- 4.1, p = 0.037) and a sinus-based cardiac rh
ythm at the time of aeromedical team arrival were predictive of surviv
al (R(2) = 0.57, p = 0.0001), Survivors were more likely to have been
transported from an outside hospital (28% vs, 8% for scene runs), had
a sinus rhythm on team arrival (42% vs, 3%), and maintained a sinus rh
ythm on arrival at the trauma center (41% vs, 0%); however, these para
meters were not predictive of survival in the statistical model, The n
eurologic outcome of the 13 survivors was good (preinjury state) in th
ree cases, moderate disability (independent living) in three, severe d
isability (needing assistance) in five, and persistent vegetative stat
e in two, Regression analysis was unable to differentiate survivors wi
th a good neurologic recovery from the rest of the patient population,
Conclusions: These results suggest that: (1) trauma patients who are
resuscitated to a sinus rhythm after OHCA should be transported to a t
rauma center; (2) Revised Trauma Score and Injury Severity Score are u
seful to predict survival; and (3) neurologic outcome is not accuratel
y predicted by this model.