Open AccessSign of Life is Associated with Return of Spontaneous Circulation After Resuscitative Thoracotomy: Single Trauma Center Experience of Republic of Korea
Author(s) -
Kang Byung Hee,
Choi Donghwan,
Huh Yo,
Kwon Junsik,
Jung Kyoungwon,
Lee John CookJong,
Moon Jonghwan
Publication year - 2019
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-019-04939-7
Subject(s) - medicine , return of spontaneous circulation , trauma center , cardiopulmonary resuscitation , advanced cardiac life support , resuscitation , thoracotomy , anesthesia , advanced life support , survival rate , retrospective cohort study , surgery
Background Resuscitative thoracotomy (RT) can be a lifesaving treatment, but it has not yet been performed in Korea. In this study, we review our experience of RT after a regional trauma center was constructed. Methods This is a retrospective study of RT conducted at a single Korean trauma center from May 2014 to March 2018. The primary outcome was survival, and the secondary outcome was return of spontaneous circulation (ROSC). The clinical characteristics of the patients were compared between the ROSC and non‐ROSC groups. Survivors were also reviewed. Results A total of 62 patients were reviewed, and 60 patients had experienced blunt injury. Thirty‐nine patients had ROSC. The ROSC group had short cardiopulmonary resuscitation (CPR) time (6 [2–10] min vs 11 [8–12] min, p < 0.001), the presence of sign of life at the trauma bay [32 (86.5%) vs 7 (28.0%), p < 0.001], and a low Injury Severity Score [26 (25–39) vs 37 (30–75), p = 0.038] compared to the non‐ROSC group. On multivariate analysis, only the presence of sign of life was significantly associated with ROSC [11.297 (1.496–85.309) OR (95% CI), p = 0.019]. The 24‐h survival rate was 8.1%, and the successful discharge rate was 4.8%. Conclusion The outcome of RT in a Korean trauma center was favorable. ROSC after RT was strongly associated with the presence of sign of life, and RT may be performed in the presence of sign of life regardless of prehospital CPR time.