Post-Resuscitation Pneumothorax - Analysis of Incidence, Risk Factors and Outcome Relevance

Study Overview
=================
Brief Summary
-----------------
In this retrospective study, the investigators seek to investigate the incidence of pneumothorax following possible risk factors, and elucidate its association with outcomes.

Detailed Description
-----------------
This is a retrospective analysis of routine data, collected by a single Emergency Medical System (EMS). Adult patients (≥18 years) hospitalised after Out-of-Hospital Cardiac Arrest (OHCA) who received chest compressions and underwent chest imaging within 12 hours after hospital admission were included. Variables and outcomes ascertained are built up of the core elements of the latest version of the Utstein Resuscitation Registry Template for OHCA. This includes sex, age, aetiology of arrest, response times of the first emergency medical service team and emergency physician, witnessed cardiac arrest, bystander CPR/AED, arrest location, first monitored rhythm, defibrillation time, drugs given, reperfusion attempted and target temperature management. Additional variables studied were pre-existing health status represented by the Pre Emergency Status Assessment (PESA), history of lung disease, no-flow-time (time from collapse until initiation of CPR), use of a mechanical chest compression device and prehospital CPR duration. The primary outcome is incidence of pneumothorax, secondary outcomes are survival to hospital discharge and favourable neurological condition at hospital discharge defined by a cerebral performance category (CPC) of 1 or 2.

Official Title
-----------------
Pneumothorax After Cardiopulmonary Resuscitation Following Out-of-Hospital Cardiac Arrest - Analysis of Incidence, Risk Factors and Impact on Outcome

Conditions
-----------------
Cardiac Arrest, Pneumothorax, Resuscitation

Intervention / Treatment
-----------------
* Procedure: Cardiopulmonary Resuscitation


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Hospitalized after out of hospital cardiac arrest Chest compressions received Chest imaging within the first 12 hours of admission Exclusion Criteria: Traumatic cardiac arrest Chest trauma/surgery/pneumothorax one month prior to cardiac arrest

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Pneumothorax<br>Patients with no pneumothorax reported from the first chest imaging after hospital admission. | Procedure: Cardiopulmonary Resuscitation<br>* Cardiopulmonary Resuscitation (Advanced Life Support) according to current guidelines<br>|
| Pneumothorax<br>Patients with a pneumothorax reported from the first chest imaging after hospital admission. | Procedure: Cardiopulmonary Resuscitation<br>* Cardiopulmonary Resuscitation (Advanced Life Support) according to current guidelines<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Presence of pneumothorax |  | within 12 hours of admission | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Survival |  | to hospital discharge (up to 2 months) | 
| Cerebral Performance Category |  | at hospital discharge (up to 2 months) |