Factors Associated with Skeletal Chest Injuries Secondary to Cardiopulmonary Resuscitation of In-Hospital Cardiac Arrest Patients.
- Author:
Jae Chul CHO
1
;
Young Woo SEO
;
Gyunmoo KIM
;
Kyung Woo LEE
;
Dai Hai CHOI
;
Tae Chang JANG
Author Information
1. Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. emzzang@cu.ac.kr
- Publication Type:Original Article
- Keywords:
Rib fractures;
Sternal fractures;
Cardiopulmonary resuscitation;
Heart arrest
- MeSH:
Cardiopulmonary Resuscitation*;
Heart Arrest*;
Humans;
Incidence;
Logistic Models;
Medical Records;
Out-of-Hospital Cardiac Arrest;
Retrospective Studies;
Rib Fractures;
Ribs;
Thoracic Injuries*;
Thorax*;
Tomography, X-Ray Computed
- From:Journal of the Korean Society of Emergency Medicine
2015;26(5):409-416
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Rib and sternal fractures are common complications of chest compressions during cardiopulmonary resuscitation (CPR). The aim of this study is to investigate skeletal chest injuries following chest compressions and factors associated with skeletal chest injuries. METHODS: A retrospective study was conducted for 10 years from January 2005 to February 2015. Skeletal chest injuries in patients who underwent computerized tomography (CT) after return of spontaneous circulation (ROSC) were analyzed. The exclusion criteria were patients with insufficient medical records, under 18 years old, traumatic cardiac arrest, and out-of-hospital cardiac arrest. RESULTS: During the period 106 patients were included. The CT scan after ROSC showed that 47 patients (44.3%) had rib fractures, and 20 patients (18.9%) had sternal fractures. The rib fracture group showed higher age (73 vs 61, p<0.001), longer CPR time (10 vs 6 min, p<0.001), and higher incidence of sternal fracture (34% vs 6.8%, p<0.001). The sternal fracture group showed longer CPR time (10 vs 7, p<0.05) and higher incidence of rib fractures (80% vs 4.7%, p<0.001). In multivariate logistic regression analysis, age (OR 1.087; 95% CI 1.041 to 1.134, p<0.001), CPR time (OR 1.200; 95% CI 1.087 to 1.323, p<0.001), and sternal fracture (OR 4.524; 95% CI 1.259 to 16.697, p=0.021) showed significant association with rib fracture. CONCLUSION: Rib and sternal fractures are frequent complications in patients who underwent CPR. In hospital cardiac arrest patients with older age, longer CPR time, and sternal fracture needed more precaution for rib fractures and other complications.
