AIM: Computed tomography (CT) has been suggested as an aid or even a replacement for autopsy. The aim of this trial was to study the conformity of the two methods in finding injuries in non-surviving patients after unsuccessful cardiopulmonary resuscitation. METHODS: In this prospective study, 31 patients were submitted to a CT prior to autopsy after unsuccessful resuscitation attempts. Pathological findings were noted by both the radiologist and the pathologists in a specified protocol. The pathologists and radiologist were blinded from each other's results. RESULTS: CT and autopsy revealed rib fractures in 22 and 24 patients respectively (kappa=0.83). In 8 patients, CT revealed more rib fractures than autopsy; and in 12 patients, autopsy revealed more rib fractures than CT. In 7 patients, neither method showed any rib fractures. The mean difference between the two methods in detecting rib fractures was 0.16 (S.D.: ± 3.174, limits of agreement: -6.19 to 6.51). The kappa value for sternal fractures was 0.49. A total of 260 pathological findings were noted by CT and 244 by autopsy. The average patient showed a median of 9 injuries (every fracture counted as one injury), independent of the method used in detecting the injuries. CONCLUSIONS: There was a strong concordance between the two methods in finding rib fractures but not sternal fractures and these results support the concept of CT as a valuable complement to autopsy in detecting rib fractures after unsuccessful cardiopulmonary resuscitation but not as a replacement. Other injuries did not show the same concordance.
RCT Entities:
AIM: Computed tomography (CT) has been suggested as an aid or even a replacement for autopsy. The aim of this trial was to study the conformity of the two methods in finding injuries in non-surviving patients after unsuccessful cardiopulmonary resuscitation. METHODS: In this prospective study, 31 patients were submitted to a CT prior to autopsy after unsuccessful resuscitation attempts. Pathological findings were noted by both the radiologist and the pathologists in a specified protocol. The pathologists and radiologist were blinded from each other's results. RESULTS: CT and autopsy revealed rib fractures in 22 and 24 patients respectively (kappa=0.83). In 8 patients, CT revealed more rib fractures than autopsy; and in 12 patients, autopsy revealed more rib fractures than CT. In 7 patients, neither method showed any rib fractures. The mean difference between the two methods in detecting rib fractures was 0.16 (S.D.: ± 3.174, limits of agreement: -6.19 to 6.51). The kappa value for sternal fractures was 0.49. A total of 260 pathological findings were noted by CT and 244 by autopsy. The average patient showed a median of 9 injuries (every fracture counted as one injury), independent of the method used in detecting the injuries. CONCLUSIONS: There was a strong concordance between the two methods in finding rib fractures but not sternal fractures and these results support the concept of CT as a valuable complement to autopsy in detecting rib fractures after unsuccessful cardiopulmonary resuscitation but not as a replacement. Other injuries did not show the same concordance.
Authors: Thomas Luiz; Alexander Wilhelms; Christian Madler; Gregor Pollach; Bernd Haaff; Joachim Grüttner; Tim Viergutz Journal: Exp Ther Med Date: 2017-02-22 Impact factor: 2.447
Authors: Jin Ho Beom; Je Sung You; Min Joung Kim; Min Kyung Seung; Yoo Seok Park; Hyun Soo Chung; Sung Phil Chung; Incheol Park Journal: Scand J Trauma Resusc Emerg Med Date: 2017-01-26 Impact factor: 2.953
Authors: Rudolph W Koster; Ludo F Beenen; Esther B van der Boom; Anje M Spijkerboer; Robert Tepaske; Allart C van der Wal; Stefanie G Beesems; Jan G Tijssen Journal: Eur Heart J Date: 2017-10-21 Impact factor: 29.983
Authors: Daniel Gödde; Florian Bruckschen; Christian Burisch; Veronika Weichert; Kevin J Nation; Serge C Thal; Stephan Marsch; Timur Sellmann Journal: Int J Environ Res Public Health Date: 2022-08-22 Impact factor: 4.614