Emergency resuscitative thoracotomy in severe trauma: Analysis of the nation‐wide registry data in Japan
Abstract Aim Emergency resuscitative thoracotomy is a potentially lifesaving procedure for patients with cardiac pulmonary arrest and profound circulatory failure resulting from a severe injury. However, survival rate post‐emergency resuscitative thoracotomy shows considerable variation, with many s...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Acute Medicine & Surgery |
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| Online Access: | https://doi.org/10.1002/ams2.958 |
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| author | Hiromu Okano Takero Terayama Hiroshi Okamoto Tsutomu Yamazaki |
| author_facet | Hiromu Okano Takero Terayama Hiroshi Okamoto Tsutomu Yamazaki |
| author_sort | Hiromu Okano |
| collection | DOAJ |
| description | Abstract Aim Emergency resuscitative thoracotomy is a potentially lifesaving procedure for patients with cardiac pulmonary arrest and profound circulatory failure resulting from a severe injury. However, survival rate post‐emergency resuscitative thoracotomy shows considerable variation, with many studies constrained by limited sample sizes and ambiguous criteria for inclusion. Herein, we assessed the outcomes of emergency resuscitative thoracotomy and identified predictors of futility using Japan Trauma Data Bank data. Methods Data of patients aged ≥18 years between 2004 and 2019 were analyzed. The primary outcome measure was survival at discharge. Descriptive statistics were used to compare the survivor and nonsurvivor groups. A multivariable logistic regression analysis was conducted to identify predictors of survival in patients undergoing emergency resuscitative thoracotomy while adjusting for confounding factors. Results Among patients who underwent emergency resuscitative thoracotomy, 684/5062 (13.5%) survived. Age <65 years (adjusted odds ratio, 1.351; 95% confidence interval, 1.130–1.615; p < 0.001), absence of cardiac pulmonary arrest on emergency department arrival (adjusted odds ratio, 1.694; 95% confidence interval, 1.280–2.243; p < 0.01), Injury Severity Score <16 (adjusted odds ratio, 2.195; 95% confidence interval, 1.611–2.992; p < 0.01), and penetrating injury (adjusted odds ratio, 1.834; 95% confidence interval, 1.384–2.431; p < 0.01) were identified as factors associated with survival at discharge. Conclusion The survival rate for emergency resuscitative thoracotomy in Japan stands at approximately 13.5%. Factors contributing to survival include younger age, absence of cardiopulmonary arrest at emergency department arrival, lack of severe trauma, and sustaining penetrating injuries. |
| format | Article |
| id | doaj-art-15b43020e1cd4b1496b1b2928d77f815 |
| institution | Kabale University |
| issn | 2052-8817 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acute Medicine & Surgery |
| spelling | doaj-art-15b43020e1cd4b1496b1b2928d77f8152024-12-30T10:18:37ZengWileyAcute Medicine & Surgery2052-88172024-01-01111n/an/a10.1002/ams2.958Emergency resuscitative thoracotomy in severe trauma: Analysis of the nation‐wide registry data in JapanHiromu Okano0Takero Terayama1Hiroshi Okamoto2Tsutomu Yamazaki3Department of Critical Care Medicine St. Luke's International Hospital Tokyo JapanDepartment of Emergency Self‐Defense Forces Central Hospital Tokyo JapanDepartment of Critical Care Medicine St. Luke's International Hospital Tokyo JapanDepartment of Social Medical Sciences, Graduate School of Medicine International University of Health and Welfare Tokyo JapanAbstract Aim Emergency resuscitative thoracotomy is a potentially lifesaving procedure for patients with cardiac pulmonary arrest and profound circulatory failure resulting from a severe injury. However, survival rate post‐emergency resuscitative thoracotomy shows considerable variation, with many studies constrained by limited sample sizes and ambiguous criteria for inclusion. Herein, we assessed the outcomes of emergency resuscitative thoracotomy and identified predictors of futility using Japan Trauma Data Bank data. Methods Data of patients aged ≥18 years between 2004 and 2019 were analyzed. The primary outcome measure was survival at discharge. Descriptive statistics were used to compare the survivor and nonsurvivor groups. A multivariable logistic regression analysis was conducted to identify predictors of survival in patients undergoing emergency resuscitative thoracotomy while adjusting for confounding factors. Results Among patients who underwent emergency resuscitative thoracotomy, 684/5062 (13.5%) survived. Age <65 years (adjusted odds ratio, 1.351; 95% confidence interval, 1.130–1.615; p < 0.001), absence of cardiac pulmonary arrest on emergency department arrival (adjusted odds ratio, 1.694; 95% confidence interval, 1.280–2.243; p < 0.01), Injury Severity Score <16 (adjusted odds ratio, 2.195; 95% confidence interval, 1.611–2.992; p < 0.01), and penetrating injury (adjusted odds ratio, 1.834; 95% confidence interval, 1.384–2.431; p < 0.01) were identified as factors associated with survival at discharge. Conclusion The survival rate for emergency resuscitative thoracotomy in Japan stands at approximately 13.5%. Factors contributing to survival include younger age, absence of cardiopulmonary arrest at emergency department arrival, lack of severe trauma, and sustaining penetrating injuries.https://doi.org/10.1002/ams2.958cardiac arrestdatabaseJapanresuscitationthoracotomy |
| spellingShingle | Hiromu Okano Takero Terayama Hiroshi Okamoto Tsutomu Yamazaki Emergency resuscitative thoracotomy in severe trauma: Analysis of the nation‐wide registry data in Japan Acute Medicine & Surgery cardiac arrest database Japan resuscitation thoracotomy |
| title | Emergency resuscitative thoracotomy in severe trauma: Analysis of the nation‐wide registry data in Japan |
| title_full | Emergency resuscitative thoracotomy in severe trauma: Analysis of the nation‐wide registry data in Japan |
| title_fullStr | Emergency resuscitative thoracotomy in severe trauma: Analysis of the nation‐wide registry data in Japan |
| title_full_unstemmed | Emergency resuscitative thoracotomy in severe trauma: Analysis of the nation‐wide registry data in Japan |
| title_short | Emergency resuscitative thoracotomy in severe trauma: Analysis of the nation‐wide registry data in Japan |
| title_sort | emergency resuscitative thoracotomy in severe trauma analysis of the nation wide registry data in japan |
| topic | cardiac arrest database Japan resuscitation thoracotomy |
| url | https://doi.org/10.1002/ams2.958 |
| work_keys_str_mv | AT hiromuokano emergencyresuscitativethoracotomyinseveretraumaanalysisofthenationwideregistrydatainjapan AT takeroterayama emergencyresuscitativethoracotomyinseveretraumaanalysisofthenationwideregistrydatainjapan AT hiroshiokamoto emergencyresuscitativethoracotomyinseveretraumaanalysisofthenationwideregistrydatainjapan AT tsutomuyamazaki emergencyresuscitativethoracotomyinseveretraumaanalysisofthenationwideregistrydatainjapan |