How does cardiac arrest of traumatic origin affect the prognosis of children?

Nieves de Lucas1,∗, Patrick Van de Voorde2, Antonio Rodríguez-Nu˜nez3, Jesús López-Herce4, Ian K. Maconochie5, Aurelie Labarre6, Edurne

López7, Rafael Mara˜nón Pardillo 4, Anil Er8, Baleine Julien 9, Sonia Ca˜nadas10, Raquel Jiménez11, Isabel Durán12, Jose Antonio Ruiz13,

Sofía Mesa14, Maria Teresa Alonso15, Maria Amalia Pérez16, Laura Perez-Gay17, José Fernández-Arribas18, Susana Hernangómez19,



1 SAMUR-Protección Civil de Madrid, Madrid, Spain

2 Ghent University Hospital, Ghent, Belgium

3 Complejo U Hospitalario de Santiago, Santiago de Compostela, Spain

4 HU Gregorio Mara˜nón, Madrid, Spain

5 Emergency Department, St Mary’s Hospital, London, United Kingdom

6 CHU de Rouen, Rouen, France

7 Hospital de Cruces, Barakaldo, Spain

8 Dr. Behcet Uz Hospital, Izmir, Turkey

9 H Montpellier, Montepellier, France

10 HU Vall d’Hebron, Barcelona, Spain

11 HU Ni˜no Jesús, Madrid, Spain

12 Regional Universitario de Málaga, Málaga, Spain

13 HU La Paz, Madrid, Spain

14 HU 12 de Octubre, Madrid, Spain

15 HU Virgen del Rocío, Sevilla, Spain

16 Hospita de Zumárraga, Zumárraga, Spain

17 HU Lugo, Lugo, Spain

18 HU Río Hortega, Valladolid, Spain

19 HU del Tajo, Aranjuez, Spain

20 GERCPPYN, Spain

Objective: To know the outcome of children who suffered from traumatic cardiac arrest (CA) compared to children with other  causes of CA, and if there are some differences in both groups  regarding to some predictors in children.

Methods: Multicentre prospective study in children until 18 years, presenting CA in an emergency prehospital or hospital service. We collected first known rhythm, lactate, pH and PELOD (Paediatric Logistic Organ Dysfunction scale) in first 24 hours. We also recorded if there was return of spontaneous circulation (ROSC), survival and POPC (Paediatric Overall Performance Category) at discharge and 6 months. We used Student test, Chi squared test and Fisher test with risk ratio (RR) and its 0.95 confidence interval in case of statistical significance.

Results: 27/188 (14.4%) were patients with traumatic CA, 62.6% male. Median age 2.5 years (range 0-17.1) There was no statistical difference in age in both groups, but we found a higher proportion of males in trauma group (88.9% vs 57.1%), p = 0.02, RR 4.9 (1.5-15.7). There were not significant differences regarding to proportion of asystole, lactate, pH or PELOD. We didn’t find any significant differences related to ROSC, sustained ROSC, POPC under 3–better outcome- at discharge or at 6 months. Nevertheless, there was worse survival at discharge in trauma patients, 12% vs 40.3%, p = 0.006, RR 1.5 (1.2-1.8) and at 6 months, 8.3% vs 30.9%, p = 0.24, RR 1.3 (1.1-1.6). Two patients survived at 6 months with POPC under 3.