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

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.