Prehospital management and outcomes of traumatic cardiac arrest in older adults: a French nationwide registry study
In brief
Older trauma-arrest patients regained circulation more often, but just 0.5% survived 30 days
In a French registry of 5,595 patients, older adults more often regained spontaneous circulation than younger adults (22.5% vs 18.6%), but fewer survived 30 days (0.5% vs 1.2%). The observational findings do not explain the survival gap; older patients also received fewer trauma-specific treatments, and clinicians should consider a medical cause of arrest without ruling out resuscitation based on age alone.
- Journal
- Resuscitation plus (Q1)
- Published
- 10 September 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Axel Benhamed, Baptiste Morcel, Jean-Stephane David, Ewoud Ter Avest, Tobias Gauss, James van Oppen, et al.
- PMID
- 42825123
- DOI
- 10.1016/j.resplu.2026.101486
Why clinicians should know about it
- Picked for Emergency Medicine (paper of the day, 4 October 2026): Duplicate entry; already assessed as relevant
Abstract
BACKGROUND: Traumatic cardiac arrest (TCA) carries an overall poor prognosis, yet the impact of advanced age on prehospital management and outcomes remains poorly characterised. Whether older patients with TCA present distinct clinical profiles or respond differently to resuscitation compared with younger adults is largely unknown. METHODS: We conducted a multicenter cohort study using data from the French National Out-of-Hospital Cardiac Arrest Registry (RéAC). All adult patients (≥18 years) with out-of-hospital TCA were included. Patients were categorised as adults (18-64 years) or older adults (≥65 years). The primary outcome was return of spontaneous circulation (ROSC). Secondary outcomes included survival at hospital admission (D0), 30-day survival (D30), and favourable neurological outcome (Cerebral Performance Category 1-2 at D30). Univariate and multivariable logistic regression analyses were performed. A pre-specified subgroup analysis stratified older patients into three age categories (65-74, 75-84, ≥85 years). RESULTS: Among 5595 patients (4249 younger adults; 1346 older adults [24.1%]), older patients more often achieved ROSC (22.5% vs 18.6%; OR 1.22, 95%CI 1.03-1.45) but were less likely to survive to 30 days (0.5% vs 1.2%; OR 0.34, 95%CI 0.15-0.81). Survival at hospital admission did not differ after adjustment (16.1% vs 13.3%; OR 1.14, 95%CI 0.95-1.38). Older patients more often sustained a fall (52.2% vs 28.5%) and less often sustained thoracic injuries (43.8% vs 59.6%). They received fewer trauma-specific prehospital interventions, most notably thoracostomy (15.2% vs 23.9%) and fluid resuscitation (28.3% vs 37.4%). CONCLUSIONS: In this large French registry study, older patients with TCA achieved return of spontaneous circulation more often than younger adults but were less likely to survive to 30 days. Age alone should not preclude resuscitative efforts, but a concurrent or precipitating medical cause of arrest should be systematically considered in this population.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.