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Analysis of trauma patient survival following emergency department thoracotomy

	Number of studies	Hospital survival	% (95% CI)
Injury mechanism
Penetrating injury	64	674/6390	10.6 (9.8-11.3)
Percentage of surviving penetrating trauma patients neurologically intact post-EDT	35	282/312	90.4 (86.7-93.3)
Gun shot wounds	44	213/2966	7.2 (6.3-8.2)
Stab wounds	44	302/1907	15.8 (14.3-17.5)
Blunt injury	42	50/2172	2.3 (1.7-3.0)
Percentage of surviving blunt trauma patients neurologically intact post-EDT	8	19/32	59.4 (41.9-75.2)
Primary injury location
Cardiac	24	250/1449	17.3 (15.4-19.3)
Thoracic	27	222/2117	10.5 (9.2-11.9)
Abdominal	22	60/856	7.0 (5.4-8.9)
Neck or extremity	8	9/128	7.0 (3.5-12.5)
Physiologic predictors
Prehospital CPR
Yes	9	22/425	5.2 (3.4-7.6)
No	8	41/301	13.6 (10.1-17.9)
ED signs of life
Yes	35	290/1523	19.0 (17.1-21.1)
No	33	62/2166	2.9 (2.2-3.6)
ED cardiac rhythm
Asystole	8	10/382	2.6 (1.4-4.6)
Pulseless electrical activity	3	17/152	11.2 (6.9-17.0)
Sinus	3	21/63	33.3 (22.6-45.6)
Other	5	4/83	4.8 (1.6-11.2)
ED vital signs
Yes	25	241/1382	17.4 (15.5-19.5)
No	35	135/3516	3.8 (3.2-4.5)
Overall
EDT hospital survival	71	871/10,238	8.5 (8.0-9.1)
EDT neuro intact hospital survival	47	408/6746	6.1 (5.5-6.6)
Percentage EDT survivors neurologically intact	45	466/544	85.7 (82.5-88.4)

All described predictors of EDT were analyzed individually across all studies.

CPR: Cardiopulmonary resuscitation; ED: Emergency department; EDT: Emergency department thoracotomy

From: Seamon MJ, Haut ER, Van Arendonk K, et al. An evidence-based approach to patient selection for emergency department thoracotomy: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg 2015; 79:159. DOI: 10.1097/TA.0000000000000648. Copyright © 2015 American Association for the Surgery of Trauma. Reproduced with permission from Wolters Kluwer Health. Unauthorized reproduction of this material is prohibited.

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