SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2019
A systematic review of 3251 emergency department thoracotomies: is it time for a national database?
Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- 2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 7. Pediatric basic life support.Clinical and experimental emergency medicine · 2026Guideline
- [Indications, procedure and outcome of prehospital emergency resuscitative thoracotomy-a systematic literature search].Der Unfallchirurg · 2020Pooled it
- [Peri-arrest emergency thoracotomy after trauma: a 5-year case series].Unfallchirurgie (Heidelberg, Germany) · 2026Article
- Unlocking survival in traumatic cardiac arrest: global insights, innovations, and unmet needs.Critical care (London, England) · 2025Review
- Survival predictor in emergency resuscitative thoracotomy for blunt trauma patients: Insights from a Chinese trauma center.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2025Article
- Development of novel thoracic retractor for resuscitative thoracotomy.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- ["Stop the bleeding"-Acute bleeding control in injuries to the trunk and extremities].Unfallchirurgie (Heidelberg, Germany) · 2023Review
- Predictors of long-term survival in 5,680 patients admitted to a UK major trauma centre with thoracic injuries.Annals of the Royal College of Surgeons of England · 2023Article
- Article
- Performance and outcome of ressucitative thoracotomies in a southern Brazil trauma center: a 7-year retrospective analysis.Revista do Colegio Brasileiro de Cirurgioes · 2022Article
- A Life Saving Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) with Open Groin Technique.Open access emergency medicine : OAEM · 2021Article
- Open-chest versus closed-chest cardiopulmonary resuscitation in trauma patients with signs of life upon hospital arrival: a retrospective multicenter study.Critical care (London, England) · 2020Article
- Improving out-of-hospital notification in traumatic cardiac arrests with novel usage of smartphone application.Journal of the American College of Emergency Physicians open · 2020Article
- Outcomes and indications for emergency thoracotomy after adoption of a more liberal policy in a western European level 1 trauma centre: 8-year experience.Updates in surgery · 2019Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeEmergency department thoracotomy (EDT) is a potentially life-saving procedure, performed on patients suffering traumatic cardiac arrest. Multiple indications have been reported, but overall survival remains unclear for each indication. The objective of this systematic review is to determine overall survival, survival stratified by indication, and survival stratified by geographical location for patients undergoing EDT across the world.
methodsArticles published between 2000 and 2016 were identified which detailed outcomes from EDT. All articles referring to pre-hospital, delayed, or operating room thoracotomy were excluded. Pooled odds ratios (OR) were calculated comparing differing indications.
resultsThirty-seven articles, containing 3251 patients who underwent EDT, were identified. There were 277 (8.5%) survivors. OR demonstrate improved survival for; penetrating vs blunt trauma (OR 2.10; p 0.0028); stab vs gun-shot (OR 5.45; p < 0.0001); signs of life (SOL) on admission vs no SOL (OR 5.36; p < 0.0001); and SOL in the field vs no SOL (OR 19.39; p < 0.0001). Equivalence of survival was demonstrated between cardiothoracic vs non-cardiothoracic injury (OR 1.038; p 1.000). Survival was worse for USA vs non-USA cohorts (OR 1.59; p 0.0012).
conclusionsPenetrating injury remains a robust indication for EDT. Non-cardiothoracic cause of cardiac arrest should not preclude EDT. In the absence of on scene SOL, survival following EDT is extremely unlikely. Survival is significantly higher in the non-USA publications; reasons for this are highly complex. A UK multicentre prospective study which collects standardised data on all EDTs could provide robust evidence for better patient stratification.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.