B Champigneulle1, P A Haruel2, R Pirracchio3, F Dumas4, G Geri5, M Arnaout6, M Paul6, F Pène6, J P Mira7, W Bougouin5, A Cariou5. 1. Medical ICU, Cochin Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France; Surgical and Trauma Intensive Care Unit, Georges Pompidou European Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France; Université Paris-Descartes-Sorbonne-Paris-Cité, Paris, France. Electronic address: benoit.champigneulle@aphp.fr. 2. Medical ICU, Cochin Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France. 3. Surgical and Trauma Intensive Care Unit, Georges Pompidou European Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France; Université Paris-Descartes-Sorbonne-Paris-Cité, Paris, France. 4. Université Paris-Descartes-Sorbonne-Paris-Cité, Paris, France; Emergency Department, Cochin-Hotel-Dieu Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France; INSERM U970 Sudden Death Expertise Center, Paris Cardiovascular Research Center, Paris, France. 5. Medical ICU, Cochin Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France; Université Paris-Descartes-Sorbonne-Paris-Cité, Paris, France; INSERM U970 Sudden Death Expertise Center, Paris Cardiovascular Research Center, Paris, France. 6. Medical ICU, Cochin Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France; Université Paris-Descartes-Sorbonne-Paris-Cité, Paris, France. 7. Medical ICU, Cochin Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France; Surgical and Trauma Intensive Care Unit, Georges Pompidou European Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France.
Abstract
AIM: Due to collapse and cardiopulmonary resuscitation (CPR) maneuvers, major traumatic injuries may complicate the course of resuscitation for out-of-hospital cardiac arrest patients (OHCA). Our goals were to assess the prevalence of these injuries, to describe their characteristics and to identify predictive factors. METHODS: We conducted an observational study over a 9-year period (2007-2015) in a French cardiac arrest (CA) center. All non-traumatic OHCA patients admitted alive in the ICU were studied. Major injuries identified were ranked using a functional two-level scale of severity (life-threatening or consequential) and were classified as CPR-related injuries or collapse-related injuries, depending of the predominant mechanism. Factors associated with occurrence of a CPR-related injury and ICU survival were identified using multivariable logistic regression. RESULTS: A major traumatic injury following OHCA was observed in 91/1310 patients (6.9%, 95%CI: 5.6, 8.3%), and was classified as a life-threatening injury in 36% of cases. The traumatic injury was considered as contributing to the death in 19 (21%) cases. Injuries were related to CPR maneuvers in 65 patients (5.0%, (95%CI: 3.8, 6.1%)). In multivariable analysis, age [OR 1.02; 95%CI (1.00, 1.04); p = 0.01], male gender [OR 0.53; 95%CI (0.31, 0.91); p = 0.02] and CA occurring at home [OR 0.54; 95%CI (0.31, 0.92); p = 0.02] were significantly associated with the occurrence of a CPR-related injury. CPR-related injuries were not associated with the ICU survival [OR 0.69; 95%CI (0.36, 1.33); p = 0.27]. CONCLUSIONS: Major traumatic injuries are common after cardiopulmonary resuscitation. Further studies are necessary to evaluate the interest of a systematic traumatic check-up in resuscitated OHCA patients in order to detect these injuries.
AIM: Due to collapse and cardiopulmonary resuscitation (CPR) maneuvers, major traumatic injuries may complicate the course of resuscitation for out-of-hospital cardiac arrestpatients (OHCA). Our goals were to assess the prevalence of these injuries, to describe their characteristics and to identify predictive factors. METHODS: We conducted an observational study over a 9-year period (2007-2015) in a French cardiac arrest (CA) center. All non-traumatic OHCApatients admitted alive in the ICU were studied. Major injuries identified were ranked using a functional two-level scale of severity (life-threatening or consequential) and were classified as CPR-related injuries or collapse-related injuries, depending of the predominant mechanism. Factors associated with occurrence of a CPR-related injury and ICU survival were identified using multivariable logistic regression. RESULTS: A major traumatic injury following OHCA was observed in 91/1310 patients (6.9%, 95%CI: 5.6, 8.3%), and was classified as a life-threatening injury in 36% of cases. The traumatic injury was considered as contributing to the death in 19 (21%) cases. Injuries were related to CPR maneuvers in 65 patients (5.0%, (95%CI: 3.8, 6.1%)). In multivariable analysis, age [OR 1.02; 95%CI (1.00, 1.04); p = 0.01], male gender [OR 0.53; 95%CI (0.31, 0.91); p = 0.02] and CA occurring at home [OR 0.54; 95%CI (0.31, 0.92); p = 0.02] were significantly associated with the occurrence of a CPR-related injury. CPR-related injuries were not associated with the ICU survival [OR 0.69; 95%CI (0.36, 1.33); p = 0.27]. CONCLUSIONS: Major traumatic injuries are common after cardiopulmonary resuscitation. Further studies are necessary to evaluate the interest of a systematic traumatic check-up in resuscitated OHCA patients in order to detect these injuries.