Cardiac arrest secondary to traumatic injury has a high mortality and poor survival. However, burden from developing countries like Pakistan remains largely unexplored due to lack of organized pre-hospital systems. In order to estimate the burden of traumatic out of hospital cardiac arrest (OHCA) we used a two-sample capture-recapture method which has been used in several domains to estimate difficult to count populations.
To explore the burden of traumatic out-of-hospital cardiac arrest in Karachi, Pakistan using two sample capture-recapture method.
We obtained three-month data from two sources: Records of two major ambulance services and five major hospitals providing coverage to city’s population. All adult patients with traumatic out-of-hospital cardiac arrest were included. Information on variables such as name, age, gender, date and time of arrest, cause of arrest and destination hospital were obtained for these cases and data from the two sources were compared to obtain a matched sample. Utilizing an equation and different levels of restrictive criteria, estimates were obtained for burden.
The EMS records reported 788 and hospital records reported 344 cases of traumatic OHCA. The capture-recapture analysis estimated the annual traumatic OHCA incidence as 114/100,000 population (95% CI: 106.8 to 121.1). Estimation of burden from individual hospital or EMS records underestimated the burden and calculated only 5.8% and 13.5% of the total burden respectively. Most of the traumatic arrest victims had gunshot wound (68.3%) followed by road traffic injuries (RTI) (24.2%).
The burden of traumatic OHCA in Pakistan is significantly larger than the burden reported by hospitals or ambulance services. Most of the cases occurred due to gunshot and RTI.
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