No-flow duration and outcomes in adult blunt traumatic out-of-hospital cardiac arrest.

Cohort studyThe American journal of emergency medicine· Jul 2026

No-flow duration and outcomes in adult blunt traumatic out-of-hospital cardiac arrest.

Yuki Kishihara, Masahiro Kashiura, Hideto Yasuda … Takashi Moriya

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Resuscitation & Cardiac ArrestCohort studyPrognosisQ1IF 2.1

No-flow time compatible with favorable neurological recovery after blunt trauma arrest was essentially zero.

No-flow duration and outcomes in adult blunt traumatic out-of-hospital cardiac arrest.

Yuki Kishihara … Takashi Moriya

The American journal of emergency medicine · Jul 2026 · Q1 in Emergency Medicine

Background

Out-of-hospital cardiac arrest (out-of-hospital cardiac arrest) due to blunt trauma has extremely poor outcomes and may have a shorter tolerable no-flow duration than nontraumatic out-of-hospital cardiac arrest.

Purpose

This study aimed to characterize the association between no-flow duration and prognosis in adults with witnessed blunt traumatic out-of-hospital cardiac arrest using dynamic probability curves.

Methods

This nationwide, population-based, retrospective cohort study used the All-Japan Utstein Registry from January 1, 2010, through December 31, 2023.

n = 9451 patients

0 (0-0) minutes

Results

0 (0-0) minutes

Even near-zero minutes without CPR carried under 1% chance of good neurological recovery.

n = 9451 patients

More results

Among 1,795,502 registry patients, 14,334 met the eligibility criteria.

Median age was 66 years, 9451 patients (65.9%) were male, and median no-flow time was 10 min.

Thirty-day favorable neurological outcome occurred in 73 patients (0.5%), and 264 patients (1.8%) survived to 30 days.

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Conclusion

Adults with witnessed out-of-hospital cardiac arrest due to blunt trauma, the no-flow duration compatible with a chance of 30-day favorable neurological outcome was extremely short, and overall prognosis was poor.

No-flow duration and outcomes in adult blunt traumatic out-of-hospital cardiac arrest.

No-flow duration and outcomes in adult blunt traumatic out-of-hospital cardiac arrest.

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