Resuscitative Thoracotomy as a Life-saving Intervention in the Emergency Department.

OBJECTIVE: To investigate the survival rate and the return of spontaneous circulation (ROSC) in patients who underwent the resuscitative thoracotomy in the emergency department (EDRT), and determine the difference in survival rate of the patients who underwent EDRT with and without out of hospital CPR.

STUDY DESIGN: Observational study.

PLACE AND DURATION OF STUDY: Department of Emergency Medicine, Edremit State Hospital, Balıkesir, Turkey between January 2014 and March 2020.

METHODOLOGY: Patients who underwent EDRT were included. Post-CPR ROSC success and 6-month survival were determined as the study endpoints. Categorical data were compared using the Chi-square test so expressed as frequency and percentage, and continuous parametric data were expressed as mean ± standard deviation (SD).

RESULTS: Twenty-seven patients were included in the study. The 6-month survival was 51.9% for all patients, and ROSC was achieved in 61.1% of patients requiring CPR. Comparing patients with and without out of hospital CPR, survival was observed in 16.7% and 80%. ROSC success was observed in 50% of patients who needed out of hospital CPR, while 83.3% for the patients with in-hospital cardiac arrest. The survival rate was 33.3% in gunshot and 80% in stab-wound injuries. Survival did not occur in patients with blunt trauma.

CONCLUSION: Performing EDRT increases the survival in penetrating injuries, especially in stab-wounds. Patients gain time for an advanced intervention. Furthermore, EDRT provides life guardians time to assess for organ donation when death is inevitable. Key Words: Blunt trauma, Cardiac arrest, CPR, Emergency thoracotomy, Gunshot injury; Organ donation, Resuscitation, Resuscitative thoracotomy, Stab-wound injury; Trauma resuscitation.