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Effect of chest compression on skeletal chest injuries: a retrospective study.

AbstractOBJECTIVE:
Reports indicate that chest compression may induce skeletal chest injuries. We aimed to assess the factors associated with skeletal chest injuries and the probability of skeletal chest injuries following cardiopulmonary resuscitation (CPR) in patients who were successfully resuscitated after cardiac arrest.
METHODS:
This retrospective analysis used data from adult patients who were successfully resuscitated after cardiac arrest. Skeletal chest injuries were assessed by chest computed tomography images. Multiple logistic regression analysis was used to identify factors associated with skeletal chest injuries and a cubic spline was fitted to visualize the predicted probability of skeletal chest injuries.
RESULTS:
Among 274 patients (mean age: 62.6 years, 180 males), 185 (68%) had skeletal chest injuries. Patients with skeletal chest injuries were older in age (66.4 ± 12 vs 54.7 ± 17 years, P < 0.001), had a higher frequency of prehospital CPR (78.9 vs 66.3%, P = 0.024), and had a longer CPR duration (26.3 ± 19.4 vs 21.5 ± 14.8 minutes, P = 0.022). Multiple logistic regression analysis showed that age and CPR duration were associated with skeletal chest injuries [odds ratio (OR): 1.06, 95% confidence interval (CI): 1.04-1.08, P < 0.001 for age; OR: 1.03, 95% CI: 1.01-1.04, P = 0.006 for CPR duration). The probability of skeletal chest injuries was higher in patients over 60 years of age than those in patients under 60 years.
CONCLUSION:
In our study, advanced age and CPR duration were factors associated with a greater risk of skeletal chest injuries in adult patients who were resuscitated after cardiac arrest.
AuthorsHyung Il Kim, Kyoung-Chul Cha, Woo Jin Chung, Young Il Noh, Oh Hyun Kim, Yong Sung Cha, Hyun Kim, Kang Hyun Lee, Hye Sim Kim, Sung Oh Hwang
JournalEuropean journal of emergency medicine : official journal of the European Society for Emergency Medicine (Eur J Emerg Med) Vol. 27 Issue 1 Pg. 59-63 (Feb 2020) ISSN: 1473-5695 [Electronic] England
PMID31306186 (Publication Type: Journal Article)
Topics
  • Age Factors
  • Aged
  • Cardiopulmonary Resuscitation (adverse effects)
  • Female
  • Fractures, Bone (etiology)
  • Heart Arrest (therapy)
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Rib Fractures (etiology)
  • Risk Factors
  • Sternum (injuries)
  • Thoracic Injuries (diagnostic imaging, etiology)
  • Tomography, X-Ray Computed

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