TRAUMA SDRUŽENÉ S RESUSCITACÍ: PŘEŽIVŠÍ VERSUS ZEMŘELÍ PACIENTI

Introduction:
CPR related injuries were not properly observed since were established new guidlines for resuscitation (CPR) 2015 with stronger recomandation for bystader and topless CPR.
Aim:
To determine impact of trauma associated with resuscitation
Methods:
Analysis of data from prospective registry of OHCA and autopsy registries of 2 high-volume Forensic medicine centers. Trauma patients were identified with clinical suspection and subsequently confirmed with imagine methods (CT, X ray, sonography). Patients died on area were investagated with autopsies. Trauma as cause of arrest was no included. To determine seriousness we used Abbreviated injury scale (AIS) and summary of all injuries with New injury severity score (NISS).
Results:
Included 859 patients with OHCA, 628 died during CPR (DEAD) and 231 were after ROSC admitted to ICU. Baseline characterist in table 1. CPR trauma was observed by 30 (13%) of survived (ICU) and 547 (87%) of dead ( p ˂0.0001). In multivariable analyses was trauma independent associated with higher age, bystander CPR, cardiac ethiology of arrest, duration of CPR and no shockable initial rythm. We compared survived with trauma and died with autopsy signs of trauma, results are shown in table 2. If we comapre injuries (Table 3), survivors have more thorax injuries, ribs fractures, strenal fractures and less liver injuries compared to died. There was no differences in seriousness of injuries measured with AIS and NISS.
Conclusions:
CPR related trauma was observed significant more by died compared to survived and is independent factor of 30-days mortality. There was no differences in seriousness of injuries measured with AIS and NISS between both groups.