Demographics, management, and outcomes of out-of-hospital traumatic cardiac arrest: a retrospective cohort study comparing children and adults

Aim: Out-of-hospital traumatic cardiac arrests (TCA) are associated with a poor prognosis, yet limited research focuses on paediatric TCA. This study aimed to compare outcomes following TCA between children and adults. Methods: We conducted a retrospective cohort study using data from the French car...

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Main Authors: Baptiste Morcel, Eric Mercier, Guillaume Debaty, Jean-Stéphane David, Etienne Javouhey, Valentine Baert, Amaury Gossiome, Francis Desmeules, Alexis Cournoyer, Karim Tazarourte, Axel Benhamed
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Resuscitation Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666520425001183
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author Baptiste Morcel
Eric Mercier
Guillaume Debaty
Jean-Stéphane David
Etienne Javouhey
Valentine Baert
Amaury Gossiome
Francis Desmeules
Alexis Cournoyer
Karim Tazarourte
Axel Benhamed
author_facet Baptiste Morcel
Eric Mercier
Guillaume Debaty
Jean-Stéphane David
Etienne Javouhey
Valentine Baert
Amaury Gossiome
Francis Desmeules
Alexis Cournoyer
Karim Tazarourte
Axel Benhamed
author_sort Baptiste Morcel
collection DOAJ
description Aim: Out-of-hospital traumatic cardiac arrests (TCA) are associated with a poor prognosis, yet limited research focuses on paediatric TCA. This study aimed to compare outcomes following TCA between children and adults. Methods: We conducted a retrospective cohort study using data from the French cardiac arrest registry (RéAC) between July 2011 and March 2023. We included all patients under 65 years who suffered a TCA managed by a mobile medical team. Patients were categorized as children (<18 years) and adults (18–65 years). The primary endpoint was the 30-day survival, and secondary endpoints were: return of spontaneous circulation (ROSC), survival at hospital admission and survival with a favourable neurological outcome (Cerebral Performance Categories 1–2) at 30 days. Results: Among 5,030 included patients, 396 were children (median age 13 [IQR 4–16] years; 73.2% male) and 4,634 were adults (median age 39 [IQR 27–51] years; 80.4% male). Paediatric patients had significantly higher rates of ROSC (25.5% vs. 20.6%, p = 0.02), survival to hospital admission (21.2% vs. 14.7%, p < 0.001), and 30-day survival (3.5% vs. 1.6%, p < 0.01). However, the proportion of patients achieving a favourable neurological outcome at 30 days did not differ significantly between groups (0.8% vs. 0.9%, p = 0.80). Conclusions: Paediatric patients with out-of-hospital TCA demonstrate higher rates of ROSC and survival compared to adults, although neurological outcomes remain poor in both populations. These findings underscore age-related disparities in TCA prognosis and highlight the need for age-specific research in TCA patients.
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spelling doaj-art-b3b7efd7f7424cb3a9b123949fe4fecc2025-08-20T03:08:56ZengElsevierResuscitation Plus2666-52042025-07-012410098110.1016/j.resplu.2025.100981Demographics, management, and outcomes of out-of-hospital traumatic cardiac arrest: a retrospective cohort study comparing children and adultsBaptiste Morcel0Eric Mercier1Guillaume Debaty2Jean-Stéphane David3Etienne Javouhey4Valentine Baert5Amaury Gossiome6Francis Desmeules7Alexis Cournoyer8Karim Tazarourte9Axel Benhamed10Service SAMU-Urgences, Centre Hospitalier Universitaire Édouard Herriot, Hospices Civils de Lyon, Lyon, FranceCentre de recherche, CHU de Québec-Université Laval, Québec, Québec, CanadaSAMU 38, Centre Hospitalier Universitaire Grenoble Alpes, 38000 Grenoble, FranceService d’anesthésie-réanimation, Centre Hospitalier Universitaire Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, FranceService d’urgences et de réanimation pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, FranceUniv. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, FranceService SAMU-Urgences, Centre Hospitalier Universitaire Édouard Herriot, Hospices Civils de Lyon, Lyon, France; Centre de recherche, CHU de Québec-Université Laval, Québec, Québec, CanadaCentre de recherche, CHU de Québec-Université Laval, Québec, Québec, CanadaCentre de Recherche de l’Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, CanadaService SAMU-Urgences, Centre Hospitalier Universitaire Édouard Herriot, Hospices Civils de Lyon, Lyon, FranceService SAMU-Urgences, Centre Hospitalier Universitaire Édouard Herriot, Hospices Civils de Lyon, Lyon, France; Centre de recherche, CHU de Québec-Université Laval, Québec, Québec, Canada; Corresponding author at: Département d’urgence CHU de Québec Centre de recherche, CHU de Québec-Université Laval, Québec, Québec, Canada.Aim: Out-of-hospital traumatic cardiac arrests (TCA) are associated with a poor prognosis, yet limited research focuses on paediatric TCA. This study aimed to compare outcomes following TCA between children and adults. Methods: We conducted a retrospective cohort study using data from the French cardiac arrest registry (RéAC) between July 2011 and March 2023. We included all patients under 65 years who suffered a TCA managed by a mobile medical team. Patients were categorized as children (<18 years) and adults (18–65 years). The primary endpoint was the 30-day survival, and secondary endpoints were: return of spontaneous circulation (ROSC), survival at hospital admission and survival with a favourable neurological outcome (Cerebral Performance Categories 1–2) at 30 days. Results: Among 5,030 included patients, 396 were children (median age 13 [IQR 4–16] years; 73.2% male) and 4,634 were adults (median age 39 [IQR 27–51] years; 80.4% male). Paediatric patients had significantly higher rates of ROSC (25.5% vs. 20.6%, p = 0.02), survival to hospital admission (21.2% vs. 14.7%, p < 0.001), and 30-day survival (3.5% vs. 1.6%, p < 0.01). However, the proportion of patients achieving a favourable neurological outcome at 30 days did not differ significantly between groups (0.8% vs. 0.9%, p = 0.80). Conclusions: Paediatric patients with out-of-hospital TCA demonstrate higher rates of ROSC and survival compared to adults, although neurological outcomes remain poor in both populations. These findings underscore age-related disparities in TCA prognosis and highlight the need for age-specific research in TCA patients.http://www.sciencedirect.com/science/article/pii/S2666520425001183Out-of-hospital cardiac arrestTraumaPaediatricsSurvivalNeurological outcome
spellingShingle Baptiste Morcel
Eric Mercier
Guillaume Debaty
Jean-Stéphane David
Etienne Javouhey
Valentine Baert
Amaury Gossiome
Francis Desmeules
Alexis Cournoyer
Karim Tazarourte
Axel Benhamed
Demographics, management, and outcomes of out-of-hospital traumatic cardiac arrest: a retrospective cohort study comparing children and adults
Resuscitation Plus
Out-of-hospital cardiac arrest
Trauma
Paediatrics
Survival
Neurological outcome
title Demographics, management, and outcomes of out-of-hospital traumatic cardiac arrest: a retrospective cohort study comparing children and adults
title_full Demographics, management, and outcomes of out-of-hospital traumatic cardiac arrest: a retrospective cohort study comparing children and adults
title_fullStr Demographics, management, and outcomes of out-of-hospital traumatic cardiac arrest: a retrospective cohort study comparing children and adults
title_full_unstemmed Demographics, management, and outcomes of out-of-hospital traumatic cardiac arrest: a retrospective cohort study comparing children and adults
title_short Demographics, management, and outcomes of out-of-hospital traumatic cardiac arrest: a retrospective cohort study comparing children and adults
title_sort demographics management and outcomes of out of hospital traumatic cardiac arrest a retrospective cohort study comparing children and adults
topic Out-of-hospital cardiac arrest
Trauma
Paediatrics
Survival
Neurological outcome
url http://www.sciencedirect.com/science/article/pii/S2666520425001183
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