Predictors of poor neurologic outcome in patients undergoing therapeutic hypothermia after cardiac arrest.
BACKGROUND: Therapeutic hypothermia (TH) has been shown to reduce the degree of anoxic brain injury, decrease mortality, and improve neurologic recovery in patients surviving cardiac arrest. However, there is a paucity of data on potential markers of neurologic outcome that physicians can use in this setting.
METHODS: A retrospective medical records review of 41 consecutive survivors of cardiac arrest treated with TH (2004-08) was examined.
RESULTS: Mean patient age was 66 years old. Most subjects had an out-of-hospital, witnessed cardiac arrest, and two-thirds had received bystander cardiopulmonary resuscitation (CPR). About half of the patients had nonventricular tachycardia/fibrillation (VT/VF) arrests. Fifty-nine percent (24 of 41 subjects) died or experienced severe neurologic impairment. By bivariate analysis, factors associated with a poor neurologic prognosis included: 1) a first rhythm at cardiac arrest other than VT/VF (P = 0.01); 2) the presence of acute kidney injury (AKI) in the intensive care unit (ICU) (P < 0.001); 3) any treated cardiac arrhythmia after admission (P = 0.05); and 4) a Glasgow Coma Score
CONCLUSION: Several simple, reproducible clinical markers can help predict neurologic recovery, during and after treatment, in patients managed with TH for cardiac arrest.
Published In/Presented At
Vanston, V. J., Lawhon-Triano, M., Getts, R., Prior, J., & Smego, R. A., Jr (2010). Predictors of poor neurologic outcome in patients undergoing therapeutic hypothermia after cardiac arrest. Southern medical journal, 103(4), 301–306. https://doi.org/10.1097/SMJ.0b013e3181d3cec2
Medicine and Health Sciences
Department of Medicine