P24 – Odds of Survival in Patients with CPR within the First Hour of Arrival to Trauma Center

Author(s):
Nasim Ahmed, John Davis, Jersey Shore University Medical Center

Background: The purpose of this study was to evaluate the factors associated with survival of patients who had CPR at the scene or within one hour of arrival to the trauma center.

Hypothesis: Odd of survival of traumatic injured patient depends upon severity of injury

Methods: Data was retrieved from the National Trauma Data Bank (NTDB) data set (RDS_2007-RDS_2010). Patients were identified cardio-pulmonary resuscitation (CPR) with Pcode( 99.6) with 0 and 1 hour of hospital arrival. In-hospital survival was the main outcome variable. Multiple logistic regression analysis was performed to assess the association between survival and the study groups . All of the tests were two-sided. A p-value of 0.05 or less was considered statistical significance

Results: Two thousand eight hundred fifty eight CPR were performed in 2733 trauma patients within one hour of hospital arrival. Two thousand three hundred ninety seven out of 2,733 (88%) died Group (I) and 336/2733 (12%) survived (group II). There were no differences between the groups regarding age (P=0.38) and gender (P=0.89). There were significant differences between the groups in terms of race (P<0.001), Injury Severity Score (ISS) [P<0.001], Glasgow Coma Scale (GCS) [P<0.001], and American College of Surgeon (ACS) level of trauma center (P<0.001). However, in multiple logistic regression analysis low ISS (P<0.001), high GCS (P<0.001), were significantly associated with survival. For each unit increase in total GCS, there was a 15% increase in survival. Similarly for each unit decrease in ISS there was a 2% increase in survival.

Conclusions: Approximately 12% of patients who had cardiopulmonary resuscitation within an hour of arrival to trauma center survived their injury. High GCS and lower ISS were associated with increased in survival.