Epidemiology of prehospital traumatic cardiac arrest in Geneva : a retrospective cohort study

Article Article scientifique Article Epidemiology of prehospital traumatic cardiac arrest in Geneva : a retrospective cohort study eng 2025-10-15 author Midez Remy 656942 author Suppan Laurent 505697 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) author Egger Coraline 752680 Département de santé et médecine communautaire (MECOM) author Jourdan Eva 659707 author Quintard Hervé 0000-0002-3870-6370 951770 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) author De Valence De Minardiere Timothee 669559 169 10.1186/s13049-025-01484-2 41094579 1757-7241 PMC12522414 https://sjtrem.biomedcentral.com/articles/10.1186/s13049-025-01484-2 Background: Traumatic cardiac arrest (TCA) has traditionally been seen as a non-survivable event. Advances in prehospital resuscitation have improved outcomes, and current guidelines emphasize addressing reversible causes of TCA, namely hypovolemia, hypoxemia, tension pneumothorax and tamponade. Understanding data on the causes and outcomes of TCA in a dense urban area may help improve treatment and prevention. Methods: We conducted a retrospective cohort study of all patients who experienced a prehospital TCA in Geneva from January 1st, 2008, to December 31st, 2022. Data was extracted from the databases of the prehospital physician-led emergency service (SMUR) and the forensic medicine service. Results: During the 15-year period, a total of 673 TCA cases were identified, of which 464 (68.9%) patients were managed by the SMUR. The average age was 52 ± 22 years, with 72.1% of males. In 90.5% of cases, the TCA occurred before the arrival of the SMUR, although emergency response times were short (8.7 min ± 4.4). 216 (46.5%) patients underwent resuscitation. Of these patients, return of spontaneous circulation (ROSC) was achieved in 71 (32.9%) and 62 patients (28.7%) survived to hospital admission. 8 patients (6 blunt, 2 penetrating) were alive at 30 days (3.7%). Pediatric TCA (< 18 years old) was rare, representing only 21 (3.1%) cases. Conclusion: Between 2008 and 2022, over 44 TCA cases per year were recorded in Geneva. Despite rapid emergency response times and ROSC achieved in more than one-third of patients who underwent resuscitation efforts, survival at 30 days was low. Factors associated with ROSC were crystalloid administration, timing of TCA, mechanism of injury, initial rhythm and the presence of an upper airway obstruction. This data underscores the need for the development and implementation of targeted interventions to enhance clinical outcomes and reduce preventable deaths within this specific patient population. Forensic medicine H.O.T.T Major trauma Prehospital emergency medicine Traumatic cardiac arrest Dewey 617 Dewey 614.1 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 67 Institut de médecine légale 22A2 false Scandinavian journal of trauma, resuscitation and emergency medicine 33 1 5b9ed54a-3882-4b8f-8fd7-ea5be98cd487 Article (Published version) Public Article_scientifique_from_crossref.pdf 1640284 application/pdf CC BY-NC-ND-4.0 f99129ccb4bd8bc09d09e4b017476e58a379341c27fc9315bc599c8e27968efc 5ea6d56a-7cd3-4fda-ac0e-af9bec7428e5 Supplemental data Public 13049_2025_1484_MOESM1_ESM.docx 30182 application/vnd.openxmlformats-officedocument.wordprocessingml.document e24c30d28be1586e0dc5f626189974a9965bd432d07294cb94e2d81b20fb0946 openAccess Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de médecine légale

Title	Published in	Access level	OA Policy	Year	Views	Downloads

Epidemiology of prehospital traumatic cardiac arrest in Geneva : a retrospective cohort study	Scandinavian journal of trauma, resuscitation and emergency medicine			2025	26	85

Archive ouverte UNIGE

Jourdan, Eva