Introduction: Traumatic cardiac arrests (TCA) resuscitation utility is often questioned. However, this question should only exist if there is a significant difference in terms of prognosis between TCA victims and their medical counterparts. No study carried out on comparable population could clarify this issue. This study objective is to compare immediate and 30 days survival between TCA and medical cardiac arrests (MCA) victims on comparable populations.
Methods: National multicentre study based on the French national cardiac arrest registry. In the first instance, we compared the two cohorts in terms of demography, care and outcome. In the second one, we compared their respective outcome on populations matched on a propensity score.
Results: We included 3,209 TCA and 40,878 MCA. TCA population was younger and more masculine. These arrests also occurred more often out of home but were less often cared by witnesses, first aid providers (Firemen) and mobile medical teams. At hospital admission as well as 30 days after cardiac arrest, survival was lower (respectively 14.0% vs 20.4%; p<0.001 and 1.5% vs 5.9%; p<0.001). Their survival chances were 2.2 times lower at hospital admission and 4.2 times lower at 30 days. After matching these differences were even more important with 14.2% vs 29.3% survival at hospital admission (p<0.001) and 1.6% vs 9.0% at 30 days (p<0.001). The gap between survival chances also widened as TCA victims chances at hospital admission were 2.4 times lower at hospital admission and 6 times lower at 30 days.
Conclusion: We observed weaknesses in the chain of survival of TCA also described in the literature. Furthermore, lower survival chances and a widened gap after propensity score matching contradicted a part of the bibliographical corpus. Hence, the question raised by American experts is indeed legit. However, survival is not anecdotic and prehospital resuscitation seems pertinent if adapted.