[Frequency of skeletal chest injuries associated with cardiopulmonary resuscitation: forensic autopsy].
BACKGROUND
Fractured ribs and sternum are frequent complications of thoracic compression during CPR (cardiopulmonary resuscitation) in adults. This study was conducted to determine the incidence of rib and sternal fractures after conventional closed-chest compression in the treatment of cardiac arrest.


METHODS
We reviewed the forensic autopsy findings of 231 deaths referred to the Pamukkale University Department of Forensic Medicine over a 12-month period, 2004-2005. CPR-related chest injuries comprising rib and sternum fractures, ecchymosis and subcostal hemorrhage were compared retrospectively in 104 patients.


RESULTS
Ninety-one (87.5%) of the 104 patients were adults, and 13 patients (12.5%) were children. The mean (SD) age in the pediatric group (5F/8M) was 5.48 (+/-5.96) and in the adult group (18F/73M) was 44.88 (+/-18.31). Forty-four (42.3%) of the 104 patients died of traumatic cause and 60 (57.7%) of non-traumatic cause. Ecchymosis was present in 26 (28.8%) patients, subcostal hemorrhage in 16 (17.6%) patients and fractures (sternal and costal) in 12 (13.2%) patients in adults. There were no significant differences between groups according to age, sex and traumatic-nontraumatic cause in terms of skeletal chest injuries associated with CPR in adult patients (p>0.05).


CONCLUSIONS
This study shows a low incidence of rib and sternal fracture after closed-chest compression in the treatment of cardiac arrest in forensic autopsy cases.
Boz
Bora
B
Department of Forensic Medicine, Pamukkale University, Denizli, Turkey.
Erdur
Bülent
B
Acar
Kemalettin
K
Ergin
Ahmet
A
Türkçüer
Ibrahim
I
Ergin
Nesrin
N
D000328:Adult; D001344:Autopsy; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D002675:Child, Preschool; D005260:Female; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D012253:Rib Fractures / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D013249:Sternum / Q000293:injuries*; D013898:Thoracic Injuries / Q000453:epidemiology* / Q000209:etiology*