Thicker Posterior Subcutaneous Adipose Tissue (SAT) and Slighter Difference of SAT During the Peri-arrest Period are Associated with Favorable Neurological Outcomes at Hospital Discharge in Patients with In-Hospital Cardiac Arrest

Abstract

Introduction:

Subcutaneous adipose tissue (SAT) and bony thorax will deform and conduct driving force during cardiac arrest (CA). The association between short-term prognosis and deformation of adult thorax for patients acquired return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation (CPR) was unclear.

Method:

Clinical records and CT images were collected from eligible patients admitted to the hospital who received CPR and achieved sustained ROSC from May 31st, 2019 to June 30, 2021. The patients were divided into different groups according to discharge outcome, then into three subgroups according to the ventilation mode before and after CPR. After that, patients with the same ventilation mode before and after CPR are combined and analyzed.

Results:

Records from 1663 patients were reviewed. After selection, 70 patients were included into this study. Significantly thicker posterior SAT post-compression was found at the 7/8/10/11 spinous process plane in patients with favorable neurological outcome (p<0.05). For patients receiving same kind of respiratory support before and after CPR, significantly thicker posterior SAT pre-compression at the 6/7/8/9/10/11 spinous plane and thicker posterior SAT post-compression at the 7/8/9/10/11/12 spinous plane (p<0.05). For patients without mechanical ventilation before or after CPR, significantly thicker posterior SAT post-compression was found at the 10/11 spinous plane in patients with favorable neurological outcome (p<0.05). For patients receiving mechanical ventilation before or after CPR, thicker posterior SAT post-compression was found at the 10/11/12 spinous plane was associated with favorable neurological outcome. No difference was found in the bony thorax within a different vertebral plane after subgroup analysis (p>0.05).

Conclusion:

Thicker posterior SAT and greater SAT depth difference after compression was associated with favorable neurological outcome at the discharge of patients who obtained ROSC after CA. A shorter duration of chest compression (<6 minutes) doesn’t cause calculable changes in patients’ bony thorax in patients who obtained ROSC after CA.