• Hyung 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, and Sung Oh Hwang.
• Department of Emergency Medicine.
• Eur J Emerg Med. 2020 Feb 1; 27 (1): 59-63.

ObjectiveReports 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.MethodsThis 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.ResultsAmong 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.ConclusionIn 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.

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