Photo Credit: Batuhan toker

The following is a summary of “Neurological outcomes in traffic accidents: A propensity score matching analysis of medical and non-medical origin cases of out-of-hospital cardiac arrest,” published in the April 2024 issue of Emergency Medicine by Miyashita, et al.

For a study, researchers sought to comprehensively compare out-of-hospital cardiac arrest (OHCA) characteristics with medical and non-medical origins related to traffic accidents and explore potential associations between cases with a medical origin and neurologically favorable outcomes.

In the retrospective nationwide population-based study, baseline data were collected between January 2018 and December 2020, analyzing 5,091 OHCA cases associated with traffic accidents on the road scene. Only cases involving treatment or transport by prehospital emergency medical technicians were included. Patients were categorized into “medical origin” and “non-medical origin” groups to analyze OHCA incident characteristics and outcomes.

Medical-origin cases exhibited distinct characteristics, including higher daytime occurrence (79.3% [706/890] vs. 68.9% [2,895/4,201], P < 0.001), higher prevalence among males (77.8% [692/890] vs. 68.3% [2,871/4,201], P < 0.001), and younger age (median [25–75%]: 63 years [42–77] vs. 66 years [50–76], P = 0.003). They also showed a higher proportion of shockable initial rhythms (10.5% [93/890] vs. 1.1% [45/4,201], P < 0.001), increased need for advanced airway management (33.8% [301/890] vs. 28.5% [1,199/4,201], P = 0.002), adrenaline administration (26.9% [239/890] vs. 21.7% [910/4201], P < 0.001), and shorter transport times (55.3% [492/890] vs. 60.9% [2,558/4,201], P = 0.002) compared to non-medical-origin cases. However, medical-origin cases had lower witness rates (42.8% [381/890] vs. 27.2% [1,142/4,201], P < 0.001) and were less likely to be transported to higher-level hospitals (55.3% [492/890] vs. 60.9% [2558/4201], P = 0.002). Propensity score matching analysis identified factors associated with favorable neurological outcomes in medical-origin traffic accidents, including shockable initial rhythms (adjusted odds ratio: 8.46 [3.47–20.61]) and cases involving medical-origin traffic accidents (adjusted odds ratio: 2.36 [1.01–5.52]), while advanced airway management showed a negative association (adjusted odds ratio: 0.09 [0.01–0.67]).

OHCA cases of medical origin related to traffic accidents were associated with favorable neurological outcomes. The cases demonstrated more favorable survival factors compared to those of non-medical origin. The findings underscored the importance of optimizing prehospital care strategies and improving survival rates for similar cases, guiding future research in public health and emergency medical services.

Reference: sciencedirect.com/science/article/abs/pii/S0735675724000299