Min Kyung Seung1, Je Sung You1, Hye Sun Lee2, Yoo Seok Park3, Sung Phil Chung1, Incheol Park1. 1. Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 2. Department of Biostatistics, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: pys0905@yuhs.ac.
Abstract
OBJECTIVE: The aim of this study was to assess whether there was a significant difference in the complications of cardiopulmonary resuscitation (CPR) between out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) survivors using multidetector computed tomography (MDCT). SUBJECTS AND METHODS: We performed a retrospective analysis of prospective registry data. We enrolled both OHCA and IHCA patients who underwent successful CPR. We classified chest injuries secondary to chest compression into rib fractures, sternum fractures, and uncommon complications such as lung contusions and extrathoracic complications. We compared these complications according to CPR locations. We also analysed risk factors for CPR complications using multiple regression analysis and classification and regression tree analysis. RESULTS: During the study period, a total of 148 patients were included in the primary analysis. Rib fractures were detected more in OHCA survivors than in IHCA survivors (74 patients (83.2%) vs. 37 patients (62.7%), p=0.05), and frequency of multiple rib fractures was higher in OHCA survivors than IHCA survivors (69 patients (77.5%) vs. 34 patients (57.6%), p=0.01). Although other complications were not significantly different between the groups, there was a trend for OHCA survivors to sustain more serious and direct high-energy related complications. Older age, longer CPR, and OHCA were significantly associated with incidence of rib fractures, multiple rib fractures, and number of rib fractures. CONCLUSIONS: Rib fractures were more likely to occur in OHCA survivors, and serious complications tended to occur more often in OHCA compared to IHCA survivors.
OBJECTIVE: The aim of this study was to assess whether there was a significant difference in the complications of cardiopulmonary resuscitation (CPR) between out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) survivors using multidetector computed tomography (MDCT). SUBJECTS AND METHODS: We performed a retrospective analysis of prospective registry data. We enrolled both OHCA and IHCA patients who underwent successful CPR. We classified chest injuries secondary to chest compression into rib fractures, sternum fractures, and uncommon complications such as lung contusions and extrathoracic complications. We compared these complications according to CPR locations. We also analysed risk factors for CPR complications using multiple regression analysis and classification and regression tree analysis. RESULTS: During the study period, a total of 148 patients were included in the primary analysis. Rib fractures were detected more in OHCA survivors than in IHCA survivors (74 patients (83.2%) vs. 37 patients (62.7%), p=0.05), and frequency of multiple rib fractures was higher in OHCA survivors than IHCA survivors (69 patients (77.5%) vs. 34 patients (57.6%), p=0.01). Although other complications were not significantly different between the groups, there was a trend for OHCA survivors to sustain more serious and direct high-energy related complications. Older age, longer CPR, and OHCA were significantly associated with incidence of rib fractures, multiple rib fractures, and number of rib fractures. CONCLUSIONS: Rib fractures were more likely to occur in OHCA survivors, and serious complications tended to occur more often in OHCA compared to IHCA survivors.
Authors: Max R Coffey; Katelynn C Bachman; Vanessa P Ho; Stephanie G Worrell; Matthew L Moorman; Philip A Linden; Christopher W Towe Journal: Eur J Trauma Emerg Surg Date: 2021-01-26 Impact factor: 3.693
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Authors: Aris Karatasakis; Basar Sarikaya; Linda Liu; Martin L Gunn; Peter J Kudenchuk; Medley O Gatewood; Charles Maynard; Michael R Sayre; Catherine R Counts; David J Carlbom; Rachael M Edwards; Kelley R H Branch Journal: J Am Heart Assoc Date: 2022-01-19 Impact factor: 6.106