Endo A, Kojima M, Hong ZJ, et al. - The effectiveness of open-chest cardiopulmonary resuscitation (OCCPR) vs closed-chest cardiopulmonary resuscitation (CCCPR) was determined in severe trauma patients with signs of life (SOL) upon arrival at the emergency department (ED). Data from the Trauma Quality Improvement Program (TQIP) database, a nationwide trauma registry in the USA, between 2010 and 2016, were analyzed in this retrospective cohort study. Evaluation of a total of 2,682 patients (OCCPR 1032; CCCPR 1650) was done; of those 157 patients (15.2%) in the OCCPR group and 193 patients (11.7%) in the CCCPR group survived. Findings here suggest that in severe trauma patients with SOL upon ED arrival, significantly higher survival at hospital discharge was achieved in correlation with OCCPR vs CCCPR.