Abstract 179: Cerebral Performance Category and Long-Term Prognosis in Cardiac Arrest Survivors

Abstract

Background: Cerebral Performance Category (CPC) is commonly used to assess neurologic outcome among cardiac arrest survivors. However the prognostic ability of the CPC is uncertain. We evaluated the association between CPC and long-term survival among persons resuscitated from out-of-hospital cardiac arrest. Methods: We conducted a cohort investigation of all persons > 18 years suffering out-of-hospital cardiac arrest in a large metropolitan EMS system between January 1, 2001 and December 31, 2009 who were resuscitated and discharged alive from the hospital. CPC was determined by review of hospital records to assess neurological status at discharge. Long-term vital status was ascertained using the state death certificate listing and the National Social Security Death Index through December 31, 2010. Kaplan-Meier was used to evaluate the association between CPC and survival. Results: During the study period 1001 adults were discharged alive following resuscitation, 980 with available CPC score. At hospital discharge, 62% had CPC of 1, 23% had CPC 2, 10% had CPC 3, and 5% had CPC 4. Average follow up was 4.8 years (SD=2.6). Overall 5-year survival was 65%. CPC was strongly associated with long-term survival, shown in Figure 1. Five year survival was 75% for CPC 1, 56% CPC 2, 48% CPC 3, and 23% for CPC 4 (log rank, p <0.0001). Conclusion: Neurological status at hospital discharge as measured by the CPC predicts long-term prognosis following resuscitation from out-of-hospital cardiac arrest. The findings support efforts designed to improve neurological recovery to achieve better long-term prognosis.