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

• Published in: BMC emergency medicine Vol. 21; no. 1; p. 148
• Main Authors: Do, Son Ngoc, Luong, Chinh Quoc, Pham, Dung Thi, Nguyen, My Ha, Ton, Tra Thanh, Hoang, Quoc Trong Ai, Nguyen, Dat Tuan, Pham, Thao Thi Ngoc, Hoang, Hanh Trong, Khuong, Dai Quoc, Nguyen, Quan Huu, Nguyen, Tuan Anh, Tran, Tung Thanh, Vu, Long Duc, Van Nguyen, Chi, McNally, Bryan Francis, Ong, Marcus Eng Hock, Nguyen, Anh Dat
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 23.11.2021; BioMed Central; BMC
• Subjects: Adult; Ambulance services; Analysis; Cardiac arrest; Cardiopulmonary Resuscitation; Cohort analysis; CPR; Critical components; Emergency medical care; Emergency Medical Services; Fatalities; First-aid; Health insurance; Heart; Heart attacks; Hospitals; Humans; Injuries; Lifesaving; Male; Medical prognosis; Medical research; Medicine, Experimental; Mortality; Organized trauma system of care; Out-of-hospital cardiac arrest; Out-of-Hospital Cardiac Arrest - etiology; Out-of-Hospital Cardiac Arrest - therapy; PAROS study; Patient outcomes; Patients; Pre-hospital care; Prognosis; Prospective Studies; Public transportation; Resuscitation; Southeast Asia; Survival; Survival Rate; Traffic; Traffic accidents & safety; Trauma; Variables; Vietnam; Vietnam - epidemiology; Vietnam; Southeast Asia; Asia; Road traffic injuries; First-aid; Pre-hospital care; Out-of-hospital cardiac arrest; Traumatic OHCA; Trauma; Emergency medical services; Organized trauma system of care; Trauma center; PAROS study
• ISSN: 1471-227X; 1471-227X
• DOI: 10.1186/s12873-021-00542-z

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. 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. 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). In this study, patients with traumatic OHCA presented to the ED with a low rate of EMS utilization and low survival rates. The poor outcomes emphasize the need for increasing bystander first-aid, developing an organized trauma system of care, and developing a standard emergency first-aid program for both healthcare personnel and the community.