Prehospital management and outcomes of traumatic cardiac arrest in older adults: a French nationwide registry study
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.
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BibTeX
@article{benhamed2026prehospital,
title = {{Prehospital management and outcomes of traumatic cardiac arrest in older adults: a French nationwide registry study}},
author = {Axel Benhamed and Baptiste Morcel and Jean-Stephane David and Ewoud ter Avest and Tobias Gauss and James van Oppen and Karim Tazarourte and Eric Mercier and Bages-Limoges Florence and Dhers Marion and Fuster Patrick and Bellow Tobola and Peguet Olivier and Besnier Sylvie and Jardel Benoit and Buleon Clement and Avondo Aurelie and Gillet Stephane and Monchard Franck and Guillaumee Frederic and Jacob Line and Kindle Carine and Marquet Jean-Luc and Watrelot Olivier and Cheminat Claude and Gonzalez Denis and Blottiaux Emmanuel and Branche Fabienne and Delemar Thibault and Ricard-Hibon Agnes and Curunet-Raoul Anne Dominique and Serre Patrice and Du Besset Marc and Poincet Geraldine and Lefevre Nathalie and Puchois Aurelien and Leraitre Thierry and Wyckaert Geoffrey and Capel Olivier and Coffin Pierre and Rebet Olivier and Thiriez Sylvain and Pinero David and Revaux Francois and Malbranque Arnaud and Moneron Martine and Dumas Franck and Hellal Meriem and Murgue Davy and Mazille Andre and Jonquet Sebastien and Poupart Patrick and Halbout Laurent and Legendre Kevin and Rouffineau Jean and Ursat Cecile and Kaliszczak Isabelle and Sejourne Gerald and Mesplede Caroline and Leroy Antoine},
journal = {Resuscitation Plus},
year = {2026},
month = oct,
doi = {10.1016/j.resplu.2026.101486},
url = {https://hal.science/hal-05799775v1},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Prehospital management and outcomes of traumatic cardiac arrest in older adults: a French nationwide registry study
AU - Axel Benhamed
AU - Baptiste Morcel
AU - Jean-Stephane David
AU - Ewoud ter Avest
AU - Tobias Gauss
AU - James van Oppen
AU - Karim Tazarourte
AU - Eric Mercier
AU - Bages-Limoges Florence
AU - Dhers Marion
AU - Fuster Patrick
AU - Bellow Tobola
AU - Peguet Olivier
AU - Besnier Sylvie
AU - Jardel Benoit
AU - Buleon Clement
AU - Avondo Aurelie
AU - Gillet Stephane
AU - Monchard Franck
AU - Guillaumee Frederic
AU - Jacob Line
AU - Kindle Carine
AU - Marquet Jean-Luc
AU - Watrelot Olivier
AU - Cheminat Claude
AU - Gonzalez Denis
AU - Blottiaux Emmanuel
AU - Branche Fabienne
AU - Delemar Thibault
AU - Ricard-Hibon Agnes
AU - Curunet-Raoul Anne Dominique
AU - Serre Patrice
AU - Du Besset Marc
AU - Poincet Geraldine
AU - Lefevre Nathalie
AU - Puchois Aurelien
AU - Leraitre Thierry
AU - Wyckaert Geoffrey
AU - Capel Olivier
AU - Coffin Pierre
AU - Rebet Olivier
AU - Thiriez Sylvain
AU - Pinero David
AU - Revaux Francois
AU - Malbranque Arnaud
AU - Moneron Martine
AU - Dumas Franck
AU - Hellal Meriem
AU - Murgue Davy
AU - Mazille Andre
AU - Jonquet Sebastien
AU - Poupart Patrick
AU - Halbout Laurent
AU - Legendre Kevin
AU - Rouffineau Jean
AU - Ursat Cecile
AU - Kaliszczak Isabelle
AU - Sejourne Gerald
AU - Mesplede Caroline
AU - Leroy Antoine
PY - 2026
DA - 2026/10/14
JO - Resuscitation Plus
DO - 10.1016/j.resplu.2026.101486
UR - https://hal.science/hal-05799775v1
AB - 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.
SN - 2666-5204
ER -