title: Chest injury following cardiopulmonary resuscitation: a prospective computed tomography evaluation.
abstract: BACKGROUND
  Traumatic chest injuries may occur following cardiopulmonary resuscitation (CPR). The aim of this study was to address the frequency of injuries, especially rib and sternal fractures, and also to identify factors that contribute to post-CPR trauma.
  
  
  METHODS
  This study was a prospective cross-sectional study conducted in the emergency departments (ED) of eight academic tertiary care centers. To evaluate injuries secondary to CPR, we performed chest computed tomography (CT) in patients who were successfully resuscitated from cardiac arrest. Contributing factors that might be related to injuries were also investigated.
  
  
  RESULTS
  We enrolled 71 patients between 1 January 2011 and 30 June 2011. Rib and sternal fractures were diagnosed in 22 and 3 patients, respectively. Females were more susceptible to rib fracture (p=0.036). When non-physicians participated as chest compressors in the ED, more ribs were fractured (p=0.048). The duration of CPR and number of compressors were not contributing factors to trauma secondary to CPR. There was a wide variation in the frequency of rib fractures from hospital to hospital (0-83.3%). In high-risk hospitals (in which more than 50% of patients had rib fractures), the average age of the patients was higher, and non-physicians took part in ED CPR more often than they did at low-risk hospitals.
  
  
  CONCLUSIONS
  The incidence of rib fracture following CPR was different in various hospitals. The presence of non-physician chest compressors in the ED was one of the contributing factors to rib fracture. Further studies on the influence of resuscitators and relation between quality of chest compression and CPR-induced injuries are warranted to reduce complications following CPR.
authors: Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Min Joung
authors: MJ
authors: Kim
authors: Yoo Seok
authors: YS
authors: Park
authors: Seung Whan
authors: SW
authors: Kim
authors: Yoo Sang
authors: YS
authors: Yoon
authors: Kyeong Ryong
authors: KR
authors: Lee
authors: Tae Ho
authors: TH
authors: Lim
authors: Hoon
authors: H
authors: Lim
authors: Ha Young
authors: HY
authors: Park
authors: Joon Min
authors: JM
authors: Park
authors: Sung Phil
authors: SP
authors: Chung
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects* / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D012253:Rib Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D013249:Sternum / Q000000981:diagnostic imaging / Q000293:injuries*; D013898:Thoracic Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods*