Chest Injuries Associated With Manual Chest Compressions in Adult Patients Who Have Suffered Out-of-Hospital Cardiac Arrest: A Retrospective Study

The aim of this retrospective observational study was to determine the incidence of chest injuries associated with manual chest compressions during cardiopulmonary resuscitation and the factors influencing their occurrence. Clinical and autopsy data were analyzed through a retrospective review of 71 autopsy reports of adult patients (58 men and 13 women) who did not survive out-of-hospital cardiac arrest. The study included cases from four municipalities in the Obalno-kraška region (Ankaran, Koper, Piran and Izola) of Slovenia, during the period from January 1, 2016 to December 31, 2020. The results showed that 42 patients (59.2%) sustained rib cage fractures following unsuccessful cardiopulmonary resuscitation. Most fractures were located between the second and sixth ribs, with the third, fourth and fifth ribs being the most frequently affected. Sternal fractures were identified in 43.6% of cases. Rib cage injuries increased with age (ρ = 0.299, P = 0.013) and were more prevalent in cardiac arrests due to drowning (P = 0.012) and those occurring in public places (P = 0.006). However, given the relatively small sample size, further research is required to confirm the factors influencing the occurrence of chest injuries.