Department of Legal Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga 520-2192, Japan.
Department of Legal Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga 520-2192, Japan.
Leg Med (Tokyo). 2021 Feb;48:101828. doi: 10.1016/j.legalmed.2020.101828. Epub 2020 Dec 11.
Cardiopulmonary resuscitation (CPR) sometime cause severe injuries and can affect quality of life, lead to long-term disabilities or death of the patient. The aim of this study is to identify the risk factors causing CPR-induced injuries and those of serious injuries.
This was a retrospective forensic autopsy study in a single institution. Among 885 forensic autopsies undertaken between 2011 and 2018, those in which the victim had undergone CPR immediately after cardiac arrest were recorded. 'Serious injuries' were defined as an Abbreviated Injury Scale (AIS) score ≥ 3. CPR-induced injuries were evaluated by three experienced forensic pathologists. With the background and history of the patient, the circumstances of cardiac arrest and risks of causing CPR-induced injuries were determined by multivariate analyses.
Seventy-five victims comprised the study cohort. CPR-induced injuries were found in 52 victims (69.3%). Rib fracture was the most common (60.0%), followed by sternal fracture (37.3%), heart injury (21.3%) and liver injury (8.0%). Multivariate analysis revealed higher age to be an independent factor causing CPR-induced injuries (odds ratio [OR], 1.07, P < 0.001). Thirty-six victims had 39 serious injuries in the chest or abdomen: fracture of ≥ 3 ribs (35 cases), aortic dissection (two), lung contusion (one) and rupture of the heart (one). Multivariate analysis revealed higher age to be an independent factor causing CPR-induced serious injuries (OR, 1.09; P < 0.001).
Aging was the significant factor causing CPR-induced injuries and serious injuries.
心肺复苏术（CPR）有时会导致严重损伤，并可能影响生活质量，导致患者长期残疾或死亡。本研究旨在确定导致 CPR 相关损伤和严重损伤的危险因素。
这是一项在单一机构进行的回顾性法医尸检研究。在 2011 年至 2018 年间进行的 885 例法医尸检中，记录了那些在心脏骤停后立即进行 CPR 的受害者。“严重损伤”定义为损伤严重程度评分（AIS）≥3。三名经验丰富的法医病理学家评估了 CPR 相关损伤。根据患者的背景和病史、心脏骤停的情况以及导致 CPR 相关损伤的风险，通过多变量分析确定。
75 名受害者组成了研究队列。52 名受害者（69.3%）发现有 CPR 相关损伤。肋骨骨折最为常见（60.0%），其次是胸骨骨折（37.3%）、心脏损伤（21.3%）和肝脏损伤（8.0%）。多变量分析显示，年龄较大是导致 CPR 相关损伤的独立因素（比值比[OR]，1.07，P<0.001）。36 名受害者的胸部或腹部有 39 处严重损伤：≥3 根肋骨骨折（35 例）、主动脉夹层（2 例）、肺挫伤（1 例）和心脏破裂（1 例）。多变量分析显示，年龄较大是导致 CPR 相关严重损伤的独立因素（OR，1.09；P<0.001）。
年龄是导致 CPR 相关损伤和严重损伤的重要因素。
