Survival after traumatic out-of-hospital cardiac arrest in Vietnam: a multicenter prospective cohort study

Survival after traumatic out-of-hospital cardiac arrest in Vietnam: a multicenter prospective cohort study

Emergency medical services, First-aid, Organized trauma system of care, Out-of-hospital cardiac arrest,
PAROS study, Pre-hospital care, Road traffic injuries, Trauma center, Trauma, Traumatic OHCA

Background: Pre-hospital services are not well developed in Vietnam, especially the lack of a trauma system of
care. Thus, the prognosis of traumatic out-of-hospital cardiac arrest (OHCA) might differ from that of other
countries. Although the outcome in cardiac arrest following trauma is dismal, pre-hospital resuscitation efforts are
not futile and seem worthwhile. Understanding the country-specific causes, risk, and prognosis of traumatic OHCA
is important to reduce mortality in Vietnam. Therefore, this study aimed to investigate the survival rate from
traumatic OHCA and to measure the critical components of the chain of survival following a traumatic OHCA in the
country.
Methods: We performed a multicenter prospective observational study of patients (> 16 years) presenting with
traumatic OHCA to three central hospitals throughout Vietnam from February 2014 to December 2018. We
collected data on characteristics, management, and outcomes of patients, and compared these data between
patients who died before hospital discharge and patients who survived to discharge from the hospital.
Results: Of 111 eligible patients with traumatic OHCA, 92 (82.9%) were male and the mean age was 39.27 years
(standard deviation: 16.38). Only 5.4% (6/111) survived to discharge from the hospital. Most cardiac arrests (62.2%;
69/111) occurred on the street or highway, 31.2% (29/93) were witnessed by bystanders, and 33.7% (32/95) were
given cardiopulmonary resuscitation (CPR) by a bystander. Only 29 of 111 patients (26.1%) were taken by the
emergency medical services (EMS), 27 of 30 patients (90%) received pre-hospital advanced airway management,
and 29 of 53 patients (54.7%) were given resuscitation attempts by EMS or private ambulance. No significant
difference between patients who died before hospital discharge and patients who survived to discharge from the
hospital was found for bystander CPR (33.7%, 30/89 and 33.3%, 2/6, P > 0.999; respectively) and resuscitation
attempts (56.3%, 27/48, and 40.0%, 2/5, P = 0.649; respectively).

Son Ngoc Do, Chinh Quoc Luong, Dung Thi Pham, My Ha Nguyen, Tra Thanh Ton, Quoc Trong Ai Hoang, Dat Tuan Nguyen, Thao Thi Ngoc Pham, Hanh Trong Hoang, Dai Quoc Khuong , Quan Huu Nguyen, Tuan Anh Nguyen, Tung Thanh Tran , Long Duc Vu, Chi Van Nguyen, Bryan Francis McNally, Marcus Eng Hock Ong and Anh Dat Nguyen

BMC Emergency Medicine

(2021) 21:148

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