Article Figures & Data
- Figure 1
PRISMA diagram. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
- Table 1
Characteristics of included studies
Study identification Design Age group Sample size Survivors (n) Mortality (%) Blunt trauma Penetrating trauma Other/unknown trauma type Alanezi45 2004 Prospective cohort Mixed 50 2 96.0 4 46 0 Barnard4 2017 Retrospective cohort Mixed 705 53 92.5 601 104 0 Beck46 2016 Retrospective cohort Mixed 1354 9 99.3 869 226 259 Calkins34 2002 Retrospective cohort Pediatric 25 2 92.0 25 0 0 Capizzani35 2010 Retrospective cohort Pediatric 30 6 80.0 21 0 9 Chia47 2017 Retrospective cohort Mixed 1554 38 97.6 NR NR 1554 Chiang etal48 2015 Retrospective cohort Adult 514 20 96.1 388 0 126 Chien49 2016 Retrospective cohort Adult 396 9 97.7 197 11 188 David50 2007 Retrospective cohort Adult 268 6 97.8 NR NR 268 Deasy51 2012 Retrospective cohort Mixed 2187 28 98.7 NR NR 2187 Di Bartolomeo19 2005 Retrospective cohort Adult 181 2 89.0 181 0 0 Djarv52 2018 Retrospective cohort Mixed 1774 65 96.3 NR NR 1774 Duchateau53 2017 Retrospective cohort Adult 88 10 88.6 77 11 0 Evans5 2016 Retrospective cohort Mixed 2300 145 92.7 1547 736 270 Falcone54 1995 Retrospective cohort Adult 320 6 98.1 285 36 0 Fisher 55 1999 Retrospective cohort Pediatric 65 1 98.5 65 0 0 Graesner56 2011 Retrospective cohort Mixed 814 221 72.9 597 52 165 Hillman57 2016 Retrospective cohort Pediatric 27 4 85.2 4 7 16 Huber-Wagner58 2007 Retrospective cohort Mixed 757 130 82.8 714 43 0 Keller37 2013 Retrospective cohort Mixed 448 37 91.7 NR NR NR Kleber23 2014 Prospective cohort Mixed 71 15 79.9 40 12 19 Lawhon20 1995 Retrospective cohort Mixed 47 2 95.7 NR NR 47 Lin59 2016 Retrospective cohort Pediatric 388 38 91.2 365 23 0 Love60 2016 Retrospective cohort Mixed 237 7 97.0 165 72 0 Lundy61 2011 Retrospective cohort Mixed 309 125 59.5 NR NR 309 Molina62 2008 Retrospective cohort Mixed 94 8 91.5 0 94 0 Mollberg63 2011 Retrospective cohort Adult 294 1 99.7 90 204 0 Moore44 2011 Prospective cohort Mixed NR 56 NR 5 51 NR Moore64 2016 Prospective cohort Adult 1708 106 93.8 820 888 0 Murphy65 2010 Retrospective cohort Pediatric 169 28 83.4 151 7 11 Perron66 2001 Retrospective cohort Pediatric 729 184 74.8 505 81 143 Pickens67 2005 Retrospective cohort Mixed 184 14 92.4 90 94 0 Powell68 2004 Retrospective cohort Mixed 959 62 93.5 11 51 897 Rabinovici69 2014 Retrospective cohort Mixed 67 9 86.6 17 50 0 Shimazu70 1983 Retrospective cohort Mixed 267 7 97.4 217 50 0 Stratton71 1998 Retrospective cohort Mixed 879 9 99.9 382 497 0 Tarmey43 2011 Prospective cohort Adult 52 4 92.3 0 17 35 Vassallo72 2019 Retrospective cohort Pediatric 129 7 94.6 110 19 0 Zwingmann73 2015 Retrospective cohort Pediatric 152 43 71.7 145 7 0 Zwingmann21 2016 Retrospective cohort Mixed 3052 649 78.7 NR NR 3052 NR, not reported.
- Table 2
Neurological outcomes of included studies
Study identification Neurological scale Time point Qualitative outcomes Good Moderate Poor Vegetative Missing Alanezi45 2004 Qualitative Discharge 1 0 1 0 0 Barnard4 2017 GOS Discharge 24* N/A 9† N/A 20 Beck46 2016 CPC Discharge 6* N/A 3 0 0 Calkins34 2002 Qualitative Discharge 2 0 0 0 0 Capizzani35 2010 Qualitative Discharge 2 1 3 0 0 Chia47 2017 CPC Discharge 15* N/A 23† N/A 0 Chiang48 2015 CPC Discharge 12* N/A 8† N/A 0 Chien49 2016 CPC Discharge 3* N/A 6† N/A 0 David50 2007 CPC Discharge 2* N/A 4† N/A 0 Deasy51 2012 GOS 1 year 0 2 2 1 23 Di Bartolomeo19 2005 GOS 4 years 0 0 2 0 0 Djarv52 2018 CPC Discharge/30 days 15 7 6 0 37 Duchateau53 2017 CPC Discharge 7 2 1 0 0 Evans5 2016 GOS Discharge 24 6 15 3 97 Falcone54 1995 Qualitative Discharge 4 0 2 0 0 Fisher55 1999 Qualitative Discharge 0 0 0 1 0 Graesner56 2011 GOS Discharge 72 53 48 40 8 Hillman57 2016 Qualitative Variable 1 0 1 0 2 Huber-Wagner58 2007 GOS Discharge 15 13 15 6 81 Keller37 2013 GOS Variable 12 2 2 1 20 Kleber23 2014 GOS Discharge 1 3 10 1 0 Lawhon20 1995 Qualitative Discharge/3 years 0 0 1 1 0 Lin59 2016 PCPC Discharge 12 26‡ N/A N/A 0 Love60 2016 Qualitative Discharge 4 0 3 0 0 Lundy61 2011 Qualitative Discharge 36 0 89 0 0 Molina62 2008 Qualitative Discharge 8 0 0 0 0 Mollberg63 2011 Qualitative Discharge 0 0 1 0 0 Moore64 2011 Qualitative Discharge 46 9 1 0 0 Moore44 2016 GOS Discharge 72 13 0 17 4 Murphy65 2010 Qualitative Discharge 16 3 7 2 0 Perron66 2001 FIM Discharge 177§ 0 7 0 0 Pickens67 2005 Qualitative Discharge 11 1 0 2 0 Powell68 2004 Qualitative Discharge 15 6 5 0 36 Rabinovici69 2014 Qualitative Discharge 7 1 1 0 0 Shimazu70 1983 Qualitative 30 days post admission 4 0 2 0 1 Stratton71 1998 CPC Discharge 3 1 2 3 0 Tarmey43 2011 GOS Discharge 4 0 0 0 0 Vassallo72 2019 GOS Discharge/30 days 2 2 1 0 2 Zwingmann73 2015 GOS After resuscitation 14 13 6 10 0 Zwingmann21 2016 GOS After resuscitation 193 201 174 81 0 Total Favorable: 992 Unfavorable: 630 Missing: 546 *Reported as good or moderate.
†Reported as poor or vegetative.
‡Reported as moderate, poor, or vegetative.
§Reported as good, moderate, or poor.
CPC, Cerebral Performance Categories; FIM, Functional Independence Measure; GOS, Glasgow Outcome Scale; N/A, not available; PCPC, Pediatric Cerebral Performance Categories.
- Table 3
Quality review of included studies
Study identification Confounding* Participant selection† Classification of interventions‡ Deviation from intended interventions§ Missing data¶ Outcomes** Selective reporting†† Overall bias Alanezi45 2004 Serious Moderate Low Moderate Low Serious Moderate Serious Barnard4 2017 Serious Moderate Low Moderate Moderate Moderate Moderate Serious Beck46 2016 Moderate Moderate Low Low Moderate Moderate Moderate Moderate Calkins34 2002 Serious Low Low Low Low Serious Moderate Serious Capizzani35 2010 Moderate Low Low Low Low Serious Moderate Serious Chia47 2017 Moderate Low Low Moderate Low Moderate Moderate Moderate Chiang48 2015 Moderate Low Low Moderate Low Moderate Low Moderate Chien49 2016 Serious Low Low Low Moderate Moderate Moderate Serious David50 2007 Moderate Low Low Moderate Low Moderate Moderate Moderate Deasy51 2012 Moderate Low Low Low Serious Moderate Moderate Serious Di Bartolomeo19 2005 Serious Low Low Low Low Moderate Moderate Serious Djarv52 2018 Moderate Low Low Low Serious Moderate Moderate Serious Duchateau53 2017 Moderate Low Low Low Low Moderate Moderate Moderate Evans44 2016 Moderate Low Low Low Moderate Moderate Moderate Moderate Falcone54 1995 Serious Low Low Moderate Low Serious Moderate Serious Fisher55 1999 Serious Low Low Moderate Low Serious Moderate Serious Graesner56 2011 Moderate Low Low Moderate Moderate Moderate Moderate Moderate Hillman57 2016 Serious Moderate Low Moderate Serious Serious Moderate Serious Huber-Wagner58 2007 Moderate Moderate Low Moderate Serious Moderate Moderate Serious Keller37 2013 Serious Serious Low Low Serious Moderate Moderate Serious Kleber23 2014 Serious Low Low Moderate Low Moderate Moderate Serious Lawhon20 1995 Serious Low Low Low Low Serious Moderate Serious Lin59 2016 Moderate Moderate Low Low Low Moderate Moderate Moderate Love60 2016 Moderate Low Low Moderate Low Serious Moderate Serious Lundy61 2011 Moderate Moderate Low Moderate Low Moderate Moderate Moderate Molina62 2008 Serious Low Low Low Low Serious Moderate Serious Mollberg63 2011 Serious Low Low Moderate Low Serious Moderate Serious Moore64 2011 Moderate Low Low Low Low Moderate Moderate Serious Moore44 2016 Moderate Low Low Low Low Moderate Moderate Moderate Murphy65 2010 Serious Low Low Low Low Serious Moderate Serious Perron66 2001 Moderate Low Low Low Serious Moderate Serious Serious Pickens67 2005 Moderate Moderate Low Low Low Moderate Moderate Moderate Powell68 2004 Serious Serious Low Low Low Moderate Moderate Serious Rabinovici69 2014 Moderate Low Low Low Low Serious Moderate Serious Shimazu70 1983 Serious Moderate Moderate Low Low Serious Moderate Serious Stratton71 1998 Moderate Low Low Low Low Moderate Moderate Moderate Tarmey43 2011 Serious Low Low Moderate Low Moderate Moderate Serious Vassallo72 2019 Serious Moderate Low Low Moderate Moderate Moderate Serious Zwingmann73 2015 Moderate Serious Low Low Low Moderate Moderate Serious Zwingmann21 2016 Moderate Serious Moderate Moderate Low Moderate Moderate Serious *Were confounding variables controlled for with statistical analysis (eg, multivariate analysis)? Did they determine these factors appropriately (eg, univariate analysis, references, subject matter expert, etc)?
†Were only survivors/non-vegetative participants assessed? Was any group excluded (eg, specific year of arrests, no rhythm on presentation, type of trauma, witnessed cardiac arrest only, etc)?
‡Was the exposure (traumatic cardiac arrest) well defined before the study? Was there a method used to identify these cases?
§Were special methods used for resuscitation (eg, therapeutic hypothermia, thoracotomy)? If so, was it reported and appropriately accounted for?
¶Were any patients lost to follow-up? Was any method used to account for this/any attempt made to recover from this? Was there a particular group of patients that were lost to follow-up?
**Was the exposure known to the person assessing neurological outcome? How were neurological outcomes assessed? Was it subjective/unclear (eg, physician-reported, self-reported, etc)? Was a standardized scale used and data reported for all categories (eg, Glasgow Outcome Scale)?
††Was there a preregistered protocol with preplanned outcomes to report? Were only specific outcomes reported in full? Were the neurological outcomes dichotomized into “good” and “poor” instead of reporting for each category?
Supplementary Materials
Supplementary data
Additional Files
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
