Benhamed, A. orcid.org/0000-0001-8784-5273, Morcel, B. orcid.org/0009-0004-4935-2661, David, J.-S. orcid.org/0000-0001-6274-7044 et al. (576 more authors) (2026) Prehospital management and outcomes of traumatic cardiac arrest in older adults: a French nationwide registry study. Resuscitation Plus. 101486. ISSN: 2666-5204
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 favorable 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 5,595 patients (4,249 younger adults; 1,346 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.
Metadata
| Item Type: | Article |
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| Authors/Creators: |
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| Copyright, Publisher and Additional Information: | © 2026 Published by Elsevier B.V. This article is available under the Creative Commons CC-BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed. |
| Keywords: | Out-of-Hospital Cardiac Arrest; Trauma; Aged; Return of Spontaneous Circulation; Survival |
| Dates: |
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| Institution: | The University of Sheffield |
| Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
| Date Deposited: | 11 Sep 2026 15:17 |
| Last Modified: | 11 Sep 2026 15:18 |
| Status: | Published online |
| Publisher: | Elsevier BV |
| Refereed: | Yes |
| Identification Number: | 10.1016/j.resplu.2026.101486 |
| Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:245396 |
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