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Comparison of complications secondary to cardiopulmonary resuscitation between out-of-hospital cardiac arrest and in-hospital cardiac arrest

Authors
 Min Kyung Seung  ;  Je Sung You  ;  Hye Sun Lee  ;  Yoo Seok Park  ;  Sung Phil Chung  ;  Incheol Park 
Citation
 Resuscitation, Vol.98 : 64-72, 2016 
Journal Title
 Resuscitation 
ISSN
 0300-9572 
Issue Date
2016
MeSH
Aged ; Cardiopulmonary Resuscitation/adverse effects* ; Female ; Heart Arrest/diagnostic imaging* ; Heart Arrest/mortality ; Heart Arrest/therapy* ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography ; Out-of-Hospital Cardiac Arrest/diagnostic imaging ; Out-of-Hospital Cardiac Arrest/mortality ; Out-of-Hospital Cardiac Arrest/therapy ; Registries ; Retrospective Studies ; Risk Factors ; Survival Rate ; Treatment Outcome
Keywords
Cardiopulmonary resuscitation ; Complication ; In-hospital cardiac arrest ; Out-of-hospital cardiac arrest
Abstract
OBJECTIVE: The aim of this study was to assess whether there was a significant difference in the complications of cardiopulmonary resuscitation (CPR) between out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) survivors using multidetector computed tomography (MDCT). SUBJECTS AND METHODS: We performed a retrospective analysis of prospective registry data. We enrolled both OHCA and IHCA patients who underwent successful CPR. We classified chest injuries secondary to chest compression into rib fractures, sternum fractures, and uncommon complications such as lung contusions and extrathoracic complications. We compared these complications according to CPR locations. We also analysed risk factors for CPR complications using multiple regression analysis and classification and regression tree analysis. RESULTS: During the study period, a total of 148 patients were included in the primary analysis. Rib fractures were detected more in OHCA survivors than in IHCA survivors (74 patients (83.2%) vs. 37 patients (62.7%), p=0.05), and frequency of multiple rib fractures was higher in OHCA survivors than IHCA survivors (69 patients (77.5%) vs. 34 patients (57.6%), p=0.01). Although other complications were not significantly different between the groups, there was a trend for OHCA survivors to sustain more serious and direct high-energy related complications. Older age, longer CPR, and OHCA were significantly associated with incidence of rib fractures, multiple rib fractures, and number of rib fractures. CONCLUSIONS: Rib fractures were more likely to occur in OHCA survivors, and serious complications tended to occur more often in OHCA compared to IHCA survivors.
Full Text
http://www.sciencedirect.com/science/article/pii/S030095721500876X
DOI
10.1016/j.resuscitation.2015.11.004
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
박유석(Park, Yoo Seok) ORCID logo https://orcid.org/0000-0003-1543-4664
박인철(Park, In Cheol) ORCID logo https://orcid.org/0000-0001-7033-766X
유제성(You, Je Sung) ORCID logo https://orcid.org/0000-0002-2074-6745
이혜선(Lee, Hye Sun) ORCID logo https://orcid.org/0000-0001-6328-6948
정성필(Chung, Sung Pil) ORCID logo https://orcid.org/0000-0002-3074-011X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146299
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