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心肺复苏后创伤:尸检结果中骨骼和内脏损伤的回顾性分析

Post-cardiopulmonary resuscitation trauma: retrospective analysis of skeletal and visceral injuries in autopsy findings.

作者信息

Deveci Cemyigit, Turgut Batuhan, Atilgan Mehmet

机构信息

Council of Forensic Medicine, Antalya Group Administration, Antalya, Türkiye.

Department of Forensic Medicine, Faculty of Medicine, Akdeniz University, Antalya, Türkiye.

出版信息

Forensic Sci Med Pathol. 2025 Jun 2. doi: 10.1007/s12024-025-01028-1.

DOI:10.1007/s12024-025-01028-1
PMID:40455121
Abstract

This study evaluates skeletal and visceral injuries associated with CPR, providing insights for clinicians and forensic experts. A retrospective analysis of 520 autopsy cases, selected from 2,508 conducted between 2021 and 2022 in Türkiye, was performed. Inclusion criteria focused on cases receiving CPR post-cardiac arrest, excluding pre-existing thoracic or abdominal trauma. Data were analyzed for demographic variables, injury types, and correlations with age, gender, and body mass index (BMI). Rib fractures were identified in 56.7% of cases, with a median of 9 fractures. Sternum fractures occurred in 42.9%, more frequently in females (55.4% vs. 38.7%; OR = 2.36, 95% CI = 1.50-3.74) and older individuals. Rib fractures were associated with age and BMI, whereas sternum fractures correlated with age and female gender. Lung (13.5%) and cardiac (5.4%) contusions were the most common. Younger individuals (0-17 years) showed fewer skeletal injuries but higher rates of isolated visceral trauma. Skeletal injuries were prevalent in individuals > 50 years, whereas visceral injuries were more common in younger cases. CPR-related injuries exhibit significant variation across demographics. Awareness of these patterns is vital for improving resuscitation protocols and post-CPR evaluations, potentially minimizing trauma.

摘要

本研究评估了与心肺复苏相关的骨骼和内脏损伤,为临床医生和法医专家提供了见解。对2021年至2022年在土耳其进行的2508例尸检病例中的520例进行了回顾性分析。纳入标准集中于心脏骤停后接受心肺复苏的病例,排除既往存在的胸部或腹部创伤。对人口统计学变量、损伤类型以及与年龄、性别和体重指数(BMI)的相关性进行了数据分析。56.7%的病例发现有肋骨骨折,中位数为9处骨折。胸骨骨折发生率为42.9%,女性(55.4%对38.7%;OR = 2.36,95%CI = 1.50 - 3.74)和老年人更常见。肋骨骨折与年龄和BMI相关,而胸骨骨折与年龄和女性性别相关。肺挫伤(13.5%)和心脏挫伤(5.4%)最为常见。年轻个体(0 - 17岁)骨骼损伤较少,但孤立性内脏创伤发生率较高。骨骼损伤在50岁以上个体中普遍存在,而内脏损伤在年轻病例中更为常见。与心肺复苏相关的损伤在不同人口统计学特征中存在显著差异。了解这些模式对于改进复苏方案和心肺复苏后评估至关重要,可能会将创伤降至最低。

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本文引用的文献

1
Study of risk factors for injuries due to cardiopulmonary resuscitation with special focus on the role of the heart: A machine learning analysis of a prospective registry with multiple sources of information (ReCaPTa Study).心肺复苏所致损伤的危险因素研究,特别关注心脏的作用:一项基于多源信息前瞻性登记系统的机器学习分析(ReCaPTa研究)
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Trauma associated with cardiopulmonary resuscitation based on autopsy reports after the 2015 ERC guidelines.基于 2015 年 ERC 指南后尸检报告的心肺复苏相关创伤。
Am J Emerg Med. 2022 Nov;61:81-86. doi: 10.1016/j.ajem.2022.08.034. Epub 2022 Aug 18.
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The clinician's guide to prevention and treatment of osteoporosis.
临床医生骨质疏松症防治指南。
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Heart injuries related to cardiopulmonary resuscitation: a risk often overlooked.心肺复苏相关的心脏损伤:一个常被忽视的风险。
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Nonskeletal injuries related to cardiopulmonary resuscitation: An autopsy study.心肺复苏相关的非骨骼损伤:一项尸检研究。
J Forensic Sci. 2021 Nov;66(6):2299-2306. doi: 10.1111/1556-4029.14791. Epub 2021 Jul 12.
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European Resuscitation Council Guidelines 2021: Executive summary.欧洲复苏理事会指南 2021:执行摘要。
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Aging is only significant factor causing CPR-induced injuries and serious injuries.年龄是导致心肺复苏引起的损伤和严重损伤的唯一重要因素。
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Updates in Traumatic Cardiac Arrest.创伤性心脏骤停的最新进展
Emerg Med Clin North Am. 2020 Nov;38(4):891-901. doi: 10.1016/j.emc.2020.06.009. Epub 2020 Sep 9.
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Cardiopulmonary resuscitation (CPR) complications encountered in forensic autopsy cases.法医学解剖案例中遇到的心肺复苏术并发症。
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