Effect of chest compression on skeletal chest injuries: a retrospective study. (February 2020)

• Record Type: Journal Article
• Authors: Kim, Hyung Il; Cha, Kyoung-Chul; Chung, Woo Jin; Noh, Young Il; Kim, Oh Hyun; Cha, Yong Sung; Kim, Hyun; Lee, Kang Hyun; Kim, Hye Sim; Hwang, Sung Oh
• Is Part Of: European journal of emergency medicine. Volume 27:Number 1(2020)
• Publication Date: 2020-02
• Subjects: basic life support -- cardiac arrest -- cardiopulmonary resuscitation -- complication; Emergency medicine -- Europe -- Periodicals; Medical emergencies -- Europe -- Periodicals; Emergency medical services -- Europe -- Periodicals; Emergencies -- Europe -- Periodicals; Emergency Medical Services -- Europe -- Periodicals; Emergency Medicine -- Europe -- periodicals; 616.025
• DOI: 10.1097/MEJ.0000000000000617
• Languages: English
• ISSNs: 0969-9546

Abstract

Abstract : Objective: 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. Abstract : Supplemental Digital Content is available in the text.