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Abstract

Introduction: Recently, ILCOR and AHA have been recommended to treat patients, who returned spontaneous circulation (ROSC) from cardiac arrest, by therapeutic hypothermia. Recently, we have tried to examine predictors, such as internal jugular venous blood oxygen saturation (SjvO2), glucagon, glucose, glial fibrillary acidic protein, procalcitonin, interleukin-8, interleutin-6, S100B and high morbidity group box 1 in serum and/or cerebrospinal fluid (CSF) within 48 hours after ROSC. But those values could not be got within a few hours except for SjvO2. Therefore, we need a predictor to detect the outcome as soon as possible for farther treatments. Methods: This retrospective cohort study included patients with ROSC after CPR who were admitted to our university hospital between January 2000 and May 2011 or an affiliated hospital between January 2006 and May 2011. Clinical parameters recorded on arrival included age (A), arterial blood pH (B), time from CPR to ROSC (C), pupil diameter (D), and initial rhythm (E). Glasgow outcome scale (GOS) was recorded at 6 months and the patients were divided according to favorable or unfavorable neurological outcomes based on GOS score. Multiple logistic regression analysis was performed to derive a formula to predict neurological outcomes based on basic clinical parameters. Results: The regression equation was derived using a teaching dataset consisting of 389 records: EP = 1/(1 + e-x), where EP is the estimated probability of having a favorable outcome, and x = (-0.034 × A) + (4.669 × B) - (0.105 × C) - (0.976 × D) + (2.603 × E) - 28.279. The sensitivity, specificity, and accuracy were 86%, 91% and 91%, respectively, for the validation dataset (n = 100). Conclusions: The 6 month neurological outcomes can be predicted in patients resuscitated from OHCA using clinical parameters that can be easily recorded at the site of CPR.