Abstract 222: Cerebral Performance Category at Hospital Discharge Predicts Long-Term Survival of Cardiac Arrest Patients Who Received Targeted Temperature Management

Abstract

Background: Little is known about the correlation between cerebral performance category (CPC) score and long-term survival of post-cardiac arrest survivors who received targeted temperature management (TTM). Methods: We performed retrospective chart review of initial cardiac arrest survivors at two tertiary academic centers from 5/2005 to 12/2012. The CPC scores at hospital discharge were determined by three independent abstractors. The 1-month, 6-month, and 12-month survival of these patients were determined by reviewing hospital records, querying the Social Security Death Index, and follow-up telephone calls. Kaplan-Meier survival estimates were calculated to compare unadjusted rates of long-term survival as well as log rank statistic to determine whether differences in survival were statistically significant. Results: Of the 2,417 identified cardiac arrest patients, 24.1% (582/2417) survived, of which 24.1% (140/582) received post-arrest TTM. The mean age of the TTM cohort was 54.4±15.7 yrs; 64.3% (90/140) were male, 43.6% (61/140) had initial shockable rhythms, and 55.7% (78/140) experienced out-of-hospital cardiac arrests. Overall, 42.9% (60/140) were discharged with CPC 1, 27.1% (38/140) with CPC 2, 18.6% (26/140) with CPC 3, and 11.4% (16/140) with CPC 4. The survival percentages of each CPC group and of the overall cohort were calculated . CPC 1 survivors had the highest long-term survival followed by CPC 2 and 3, with CPC 4 having the lowest long-term survival (p < 0.001, log-rank test). Conclusion: Patients with different CPC scores at discharge have significantly divergent survival trajectories. Favorable CPC at hospital discharge predicts better long-term outcomes of cardiac arrest survivors who received TTM than those with less favorable CPC scores. Further studies and neurocognitive testing of these survivors may help to predict the duration and types of outpatient resources necessary after their hospital discharge.