Abstract 11948: Late Improvement of Neurological Function After Out-of-Hospital Cardiopulmonary Arrest: Incidence, Prevalence, and Predictors
Introduction: Optimal times for follow-up after cardiac arrest have yet to be established in patients with out-of-hospital cardiopulmonary arrest (OHCA).
Hypothesis: We assessed the hypothesis that long-term neurological function after OHCA improves over time according to the patients’ characteristics and cerebral circumstances at the time of hospital arrival.
Methods: J-POP registry is a prospective, multicenter, and cohort study in Japan to test whether regional cerebral oxygen saturation (rSO2) predicts neurological outcomes after non-traumatic OHCA. We measured the rSO2 in OHCA patients immediately after hospital arrival by using a near-infrared spectrometer placed on the forehead. Primary endpoints are the Cerebral Performance Category (CPC; ranging from 1 [good performance] to 5 [brain death]) at 30 and 90 days after OHCA.
Results: Since Japanese emergency medical service providers are not permitted to terminate resuscitation in the field, most patients with OHCA are transported to emergency hospitals. During the 20.5-month study period, 1719 consecutive patients were examined, 1663 of whom were evaluated at 30 and 90 days after OHCA. Out of 24 patients with CPC3 (severe disability) at 30 days after OHCA, we found that the neurological status improved to CPC1 and CPC2 at 90 days after OHCA in 6 patients (25%); these 6 patients were found to be younger than the patients without any improvement in neurological status. There was no difference in the other patient characteristics and rSO2 at the time of hospital arrival between the 2 groups (See Figure).
Conclusions: In conclusion, we found an improvement in the neurological status at 90 days after OHCA in 25% of the patients who had a moderate neurological deficit at 30 days after OHCA. Patient age was a significant predictor for late neurological improvement. Other patient characteristics and cerebral circumstances at the time of hospital arrival had no influence on the incidence of late neurological improvement.
- © 2013 by American Heart Association, Inc.