Abstract 165: Initial Middle Latency Auditory Evoked Potentials Index Helps to Predict Neurological Outcomes in Patients With Out-of-Hospital Return of Spontaneous Circulation (OH-ROSC)
Objective: Survival rates for cardiac arrest are known to be higher with out-of-hospital return of spontaneous circulation (OH-ROSC). However, data pertaining to OH-ROSC is limited. We speculated that initial middle latency auditory evoked potential index (MLAEPi) measured using an MLAEPi monitor (Fig.) at the emergency department (ED) can predict neurological outcomes among patients with OH-ROSC.
Design: A prospective study Setting: A tertiary emergency center in Tokyo, Japan (January 2012 to May 2013).
Patients: A total of 23 patients who had witnessed cardiac arrest and determined OH-ROSC after undergoing cardiopulmonary resuscitation (CPR).
Measurements and Results: The parameters comprised, age, gender, medical history, Glasgow Coma Scale (GCS), vital signs, blood gas, initial electrical rhythm, MLAEPi, bystander CPR, resuscitation intervals and neurological outcome. Neurological outcomes were evaluated 3 months after OH-ROSC, using cerebral performance category (CPC) score and classified into two groups: good outcome (GO) for a score of 1 or 2, and worse outcome (WO) for a score of 3-5. Among 23 patients with OH-ROSC, 10 patients were grouped under GO (CPC 1, n = 5; CPC 2, n = 5) and 13 were grouped under WO (CPC 3, n = 2; CPC 4, n = 6 and CPC 5, n = 5). The following values were significantly better in cases with GO than in those with WO (p < 0.05): gender, resuscitation intervals, MLAEPi, base excess, pH, respiratory rate, initial VF and the motor response of initial GCS score. The receiver operating characteristic curves for the initial MLAEPi with area under the curves was 0.92 (95% CI, 0.81-1.03; p < 0.01) and the sensitivity was 100% for initial MLAEPi cut-offs of 50 to predict good neurological outcome.
Conclusion: Among patients with OH-ROSC, the initial MLAEPi at the ED was strongly associated with good neurological outcomes at 3 month after the event.
- © 2013 by American Heart Association, Inc.