Impact of the 2015 European guidelines for resuscitation on traumatic cardiac arrest outcomes and prehospital management: a French nationwide interrupted time-series analysis. - Université de Lille Accéder directement au contenu
Article Dans Une Revue Resuscitation Année : 2023

Impact of the 2015 European guidelines for resuscitation on traumatic cardiac arrest outcomes and prehospital management: a French nationwide interrupted time-series analysis.

Résumé

Aim To evaluate the impact of the 2015 European Resuscitation Council (ERC) guidelines on patient outcomes following traumatic cardiac arrest (TCA) and on advanced life support interventions carried out by physician-staffed ambulances. Methods Data of TCA patients aged ≥18 years were extracted from the French nationwide cardiac arrest registry. A pre- (2011–2015) and a post-publication period (2016–2020) were defined. In the guidelines, a specific TCA management algorithm was introduced to prioritise the treatment of reversible causes. Its impact was evaluated using adjusted interrupted time series analysis. Results 4,980 patients were treated (2,145 during the pre-publication period and 2,739 during the post-publication period). There was no significant change in the rates of prehospital ROSC (22.4% vs. 20.2%, p = 0.07 in the pre- and post- intervention respectively), survival (1.4% vs. 1.4%, p = 0.87) or good neurological outcome (71.4% vs. 66.7%, p = 0.93) or in the incidence of organ donation (1.6% vs. 1.3%, p = 0.50). There were nonsignificant changes in the adjusted temporal trend for ROSC (aOR 0.88; 95% CI [0.77; 1.00]), survival (aOR 1.34; 95% CI [0.83;2.17]), good neurological outcome (aOR 1.57; 95% CI [0.82;3.05]), and organ donation (aOR 1.06; 95% CI [0.71;1.60]). The use of intraosseous catheters (13.0% vs. 19.2%, p < 0.001), external haemorrhage control measures (23.9% vs. 64.8%, p < 0.001), bilateral chest decompression (13.7% vs. 16.5%, p = 0.009), and packed red cell transfusion (2.7% vs. 6.5%, p < 0.001) increased in the post-publication period. Conclusions Despite the increased frequency of trauma rescue interventions performed by on-scene physicians, no change in patient-centred outcomes was associated with the publication of the 2015 ERC guidelines in France.
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hal-04530548 , version 1 (03-04-2024)

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Axel Benhamed, Eric Mercier, Julie Freyssenge, Mathieu Heidet, Tobias Gauss, et al.. Impact of the 2015 European guidelines for resuscitation on traumatic cardiac arrest outcomes and prehospital management: a French nationwide interrupted time-series analysis.. Resuscitation, 2023, Resuscitation, pp.109763. ⟨10.1016/j.resuscitation.2023.109763⟩. ⟨hal-04530548⟩
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