The Association Between the Duration of Chest Compression and Thoracic Injuries in Patients With Non-Traumatic Out-of-Hospital Cardiac Arrest.

Autor:	Katasako A; Department of Cardiology, Aso Iizuka Hospital., Kawakami S; Department of Cardiology, Aso Iizuka Hospital., Koga H; Clinical Research Support Office, Aso Iizuka Hospital., Kitahara K; Department of Cardiology, Aso Iizuka Hospital., Komiya K; Department of Cardiology, Aso Iizuka Hospital., Mizokami K; Department of Cardiology, Aso Iizuka Hospital., Yamada T; Department of Emergency Medicine, Aso Iizuka Hospital., Miura N; Department of Radiology, Aso Iizuka Hospital., Inoue S; Department of Cardiology, Aso Iizuka Hospital.
Jazyk:	angličtina
Zdroj:	Circulation journal : official journal of the Japanese Circulation Society [Circ J] 2022 Sep 22; Vol. 86 (10), pp. 1572-1578. Date of Electronic Publication: 2022 Sep 02.
DOI:	10.1253/circj.CJ-22-0193
Abstrakt:	Background: Current guidelines emphasize the indispensability of high-quality chest compression for improving survival in patients who experience out-of-hospital cardiac arrest (OHCA). However, chest compression can cause thoracic injuries that may contribute to poor prognosis; therefore, the purpose of this study is to identify the predictors of thoracic injuries and evaluate the association between thoracic injuries and prognosis. Methods and results: Between June 2017 to July 2019, Utstein-style data on 384 consecutive adult patients who experienced non-traumatic OHCA and who were transferred to our hospital (Aso Iizuka Hospital) were collected. Each patient underwent a full-body computed tomography scan. Two-hundred and thirty-four patients (76%) had thoracic injuries (Group-T). The duration of chest compression was significantly longer in Group-T than in patients without thoracic injuries (Group-N; 43 vs. 32 min, respectively, P<0.001). Multivariate analysis revealed that older age and longer chest compression duration were predictors of thoracic injuries (odds ratios 1.03 and 1.07, respectively, P≤0.005). Among patients who achieved return of spontaneous circulation, Kaplan-Meier curves showed a significantly higher cumulative survival rate in Group-N than in Group-T at the 30-day follow up (log-rank test P=0.009). Conclusions: Older age and longer chest compression duration were independent predictors of thoracic injuries due to chest compression in patients who experienced non-traumatic OHCA. Moreover, the presence of thoracic injuries was associated with worse short-term prognosis.
Databáze:	MEDLINE
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