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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)

García-Vilana, Silvia ; Kumar, Vikas ; Kumar, Saurav ; Barberia, Eneko ; Landín, Inés ; Granado-Font, Ester ; Solà-Muñoz, Silvia ; Jiménez-Fàbrega, Xavier ; Bardají, Alfredo and Madsen Hardig, Bjarne LU , et al. (2024) In Resuscitation Plus 17.
Abstract

Background: The study of thoracic injuries and biomechanics during CPR requires detailed studies that are very scarce. The role of the heart in CPR biomechanics has not been determined. This study aimed to determine the risk factors importance for serious ribcage damage due to CPR. Methods: Data were collected from a prospective registry of out-of-hospital cardiac arrest between April 2014 and April 2017. This study included consecutive out-of-hospital CPR attempts undergoing an autopsy study focused on CPR injuries. Cardiac mass ratio was defined as the ratio of real to expected heart mass. Pearson's correlation coefficient was used to select clinically relevant variables and subsequently classification tree models were built. The Gini... (More)

Background: The study of thoracic injuries and biomechanics during CPR requires detailed studies that are very scarce. The role of the heart in CPR biomechanics has not been determined. This study aimed to determine the risk factors importance for serious ribcage damage due to CPR. Methods: Data were collected from a prospective registry of out-of-hospital cardiac arrest between April 2014 and April 2017. This study included consecutive out-of-hospital CPR attempts undergoing an autopsy study focused on CPR injuries. Cardiac mass ratio was defined as the ratio of real to expected heart mass. Pearson's correlation coefficient was used to select clinically relevant variables and subsequently classification tree models were built. The Gini index was used to determine the importance of the associated serious ribcage damage factors. The LUCAS® chest compressions device forces and the cardiac mass were analyzed by linear regression. Results: Two hundred CPR attempts were included (133 manual CPR and 67 mechanical CPR). The mean age of the sample was 60.4 ± 13.5, and 56 (28%) were women. In all, 65.0% of the patients presented serious ribcage damage. From the classification tree build with the clinically relevant variables, age (0.44), cardiac mass ratio (0.26), CPR time (0.22), and mechanical CPR (0.07), in that order, were the most influential factors on serious ribcage damage. The chest compression forces were greater in subjects with higher cardiac mass. Conclusions: The heart plays a key role in CPR biomechanics being cardiac mass ratio the second most important risk factor for CPR injuries.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Biomechanics, Cardiac arrest, Cardiopulmonary resuscitation, Heart, Thoracic injuries
in
Resuscitation Plus
volume
17
article number
100559
publisher
Elsevier
external identifiers
  • scopus:85183995227
ISSN
2666-5204
DOI
10.1016/j.resplu.2024.100559
language
English
LU publication?
yes
id
193c9d55-67bf-4622-a46a-781756320ad1
date added to LUP
2024-03-05 12:07:35
date last changed
2024-03-05 12:07:35
@article{193c9d55-67bf-4622-a46a-781756320ad1,
  abstract     = {{<p>Background: The study of thoracic injuries and biomechanics during CPR requires detailed studies that are very scarce. The role of the heart in CPR biomechanics has not been determined. This study aimed to determine the risk factors importance for serious ribcage damage due to CPR. Methods: Data were collected from a prospective registry of out-of-hospital cardiac arrest between April 2014 and April 2017. This study included consecutive out-of-hospital CPR attempts undergoing an autopsy study focused on CPR injuries. Cardiac mass ratio was defined as the ratio of real to expected heart mass. Pearson's correlation coefficient was used to select clinically relevant variables and subsequently classification tree models were built. The Gini index was used to determine the importance of the associated serious ribcage damage factors. The LUCAS® chest compressions device forces and the cardiac mass were analyzed by linear regression. Results: Two hundred CPR attempts were included (133 manual CPR and 67 mechanical CPR). The mean age of the sample was 60.4 ± 13.5, and 56 (28%) were women. In all, 65.0% of the patients presented serious ribcage damage. From the classification tree build with the clinically relevant variables, age (0.44), cardiac mass ratio (0.26), CPR time (0.22), and mechanical CPR (0.07), in that order, were the most influential factors on serious ribcage damage. The chest compression forces were greater in subjects with higher cardiac mass. Conclusions: The heart plays a key role in CPR biomechanics being cardiac mass ratio the second most important risk factor for CPR injuries.</p>}},
  author       = {{García-Vilana, Silvia and Kumar, Vikas and Kumar, Saurav and Barberia, Eneko and Landín, Inés and Granado-Font, Ester and Solà-Muñoz, Silvia and Jiménez-Fàbrega, Xavier and Bardají, Alfredo and Madsen Hardig, Bjarne and Azeli, Youcef}},
  issn         = {{2666-5204}},
  keywords     = {{Biomechanics; Cardiac arrest; Cardiopulmonary resuscitation; Heart; Thoracic injuries}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Resuscitation Plus}},
  title        = {{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)}},
  url          = {{http://dx.doi.org/10.1016/j.resplu.2024.100559}},
  doi          = {{10.1016/j.resplu.2024.100559}},
  volume       = {{17}},
  year         = {{2024}},
}