Rutsuko Yamaguchi1,2, Yohsuke Makino3,4,5, Fumiko Chiba3,4, Suguru Torimitsu3,4, Daisuke Yajima4, Go Inokuchi4, Ayumi Motomura4, Mari Hashimoto3,4, Yumi Hoshioka4, Tomohiro Shinozaki6, Hirotaro Iwase3,4. 1. Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. rymgch@m.u-tokyo.ac.jp. 2. Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba Prefecture, 260-8670, Japan. rymgch@m.u-tokyo.ac.jp. 3. Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. 4. Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba Prefecture, 260-8670, Japan. 5. Education and Research Center of Legal Medicine, Department of Forensic Radiology and Imaging, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba Prefecture, 260-8670, Japan. 6. Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Abstract
AIM: To determine the frequency of cardiopulmonary resuscitation (CPR)-related injuries and factors involved in their occurrence, data based on forensic autopsy and postmortem computed tomography (PMCT) during implementation of the 2010 American Heart Association Guidelines for CPR were studied. METHODS: We retrospectively evaluated data on adult patients with non-traumatic deaths who had undergone manual CPR and autopsy from January 2012 to December 2014. CPR-related injuries were analyzed on autopsy records and PMCT images and compared with results of previous studies. RESULTS: In total, 180 consecutive cases were analyzed. Rib fractures and sternal fractures were most frequent (overall frequency, 66.1 and 52.8%, respectively), followed by heart injuries (12.8%) and abdominal visceral injuries (2.2%). Urgently life-threatening injuries were rare (2.8%). Older age was an independent risk factor for rib fracture [adjusted odds ratio (AOR), 1.06; 95% confidence interval (CI), 1.04-1.08; p < 0.001], ≥ 3 rib fractures (AOR, 1.06; 95% CI, 1.02-1.09; p = 0.002), and sternal fracture (AOR, 1.03; 95% CI, 1.01-1.05; p < 0.001). Female sex was significantly associated with sternal fracture (AOR, 2.08; 95% CI, 1.02-4.25; p = 0.04). Chest compression only by laypersons was inversely associated with rib and sternal fractures. Body mass index and in-hospital cardiac arrest were not significantly associated with any complications. The frequency of thoracic skeletal injuries was similar to that in recent autopsy-based studies. CONCLUSIONS: Implementation of the 2010 Guidelines had little impact on the frequency of CPR-related thoracic skeletal injuries or urgently life-threatening complications. Older age was the only independent factor related to thoracic skeletal injuries.
AIM: To determine the frequency of cardiopulmonary resuscitation (CPR)-related injuries and factors involved in their occurrence, data based on forensic autopsy and postmortem computed tomography (PMCT) during implementation of the 2010 American Heart Association Guidelines for CPR were studied. METHODS: We retrospectively evaluated data on adult patients with non-traumatic deaths who had undergone manual CPR and autopsy from January 2012 to December 2014. CPR-related injuries were analyzed on autopsy records and PMCT images and compared with results of previous studies. RESULTS: In total, 180 consecutive cases were analyzed. Rib fractures and sternal fractures were most frequent (overall frequency, 66.1 and 52.8%, respectively), followed by heart injuries (12.8%) and abdominal visceral injuries (2.2%). Urgently life-threatening injuries were rare (2.8%). Older age was an independent risk factor for rib fracture [adjusted odds ratio (AOR), 1.06; 95% confidence interval (CI), 1.04-1.08; p < 0.001], ≥ 3 rib fractures (AOR, 1.06; 95% CI, 1.02-1.09; p = 0.002), and sternal fracture (AOR, 1.03; 95% CI, 1.01-1.05; p < 0.001). Female sex was significantly associated with sternal fracture (AOR, 2.08; 95% CI, 1.02-4.25; p = 0.04). Chest compression only by laypersons was inversely associated with rib and sternal fractures. Body mass index and in-hospital cardiac arrest were not significantly associated with any complications. The frequency of thoracic skeletal injuries was similar to that in recent autopsy-based studies. CONCLUSIONS: Implementation of the 2010 Guidelines had little impact on the frequency of CPR-related thoracic skeletal injuries or urgently life-threatening complications. Older age was the only independent factor related to thoracic skeletal injuries.
Authors: Robert A Berg; Robin Hemphill; Benjamin S Abella; Tom P Aufderheide; Diana M Cave; Mary Fran Hazinski; E Brooke Lerner; Thomas D Rea; Michael R Sayre; Robert A Swor Journal: Circulation Date: 2010-11-02 Impact factor: 29.690
Authors: E Perers; P Abrahamsson; A Bång; J Engdahl; J Lindqvist; B W Karlson; L Waagstein; J Herlitz Journal: Resuscitation Date: 1999 Apr-May Impact factor: 5.262
Authors: Jim Christenson; Douglas Andrusiek; Siobhan Everson-Stewart; Peter Kudenchuk; David Hostler; Judy Powell; Clifton W Callaway; Dan Bishop; Christian Vaillancourt; Dan Davis; Tom P Aufderheide; Ahamed Idris; John A Stouffer; Ian Stiell; Robert Berg Journal: Circulation Date: 2009-09-14 Impact factor: 29.690
Authors: Dana P Edelson; Barbara Litzinger; Vineet Arora; Deborah Walsh; Salem Kim; Diane S Lauderdale; Terry L Vanden Hoek; Lance B Becker; Benjamin S Abella Journal: Arch Intern Med Date: 2008-05-26
Authors: Benjamin Ondruschka; Christina Baier; Ronny Bayer; Niels Hammer; Jan Dreßler; Michael Bernhard Journal: Forensic Sci Med Pathol Date: 2018-09-10 Impact factor: 2.007
Authors: John Adel; Muharrem Akin; Vera Garcheva; Jens Vogel-Claussen; Johann Bauersachs; L Christian Napp; Andreas Schäfer Journal: Front Cardiovasc Med Date: 2022-02-03
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