title: Comparison of complications secondary to cardiopulmonary resuscitation between out-of-hospital cardiac arrest and in-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).
  
  
  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.
authors.affiliation: Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Min Kyung
authors.initials: MK
authors.lastname: Seung
authors.affiliation: Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Je Sung
authors.initials: JS
authors.lastname: You
authors.affiliation: Department of Biostatistics, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: pys0905@yuhs.ac.
authors.forename: Yoo Seok
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung Phil
authors.initials: SP
authors.lastname: Chung
authors.affiliation: Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Incheol
authors.initials: I
authors.lastname: Park
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D005260:Female; D006323:Heart Arrest / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D058687:Out-of-Hospital Cardiac Arrest / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Cardiopulmonary resuscitation; Complication; In-hospital cardiac arrest; Out-of-hospital cardiac arrest