Abstract 420: Comparison of Prognostic Predictors After Return of Spontaneous Circulation Between Cardiac and Non-Cardiac Cardiopulmonary Arrest

Abstract

Introduction: Understanding the characteristics of survivor after return of spontaneous circulation (ROSC) in patients with cardiopulmonary arrest (CPA) may help us to select the optimal management. Hypothesis: We hypothesized that the prognosis and predictors of survivor after ROSC could be different between cardiac and non-cardiac CPA patients. Method: We retrospectively analyzed consecutive 85 patients with CPA and ROSC after cardiopulmonary resuscitation (CPR) in our hospital and divided them into cardiogenic (n=35) and non-cardiogenic (n=50) CPA. We analyzed age, gender, bystander CPR, duration of CPA, pupil diameter at admission, Glasgow coma scale, total protein (TP) level, creatinine level, pH of arterial blood and death in hospital. Result: The 17 patients died in cardiogenic CPA and 40 patients in non-cardiogenic CPA. The Kaplan-Meier curve demonstrated the better prognosis in cardiogenic CPA compared with non-cardiogenic CPA (Figure). In both CPA, duration of CPA was shorter and total TP level was higher in survival than those in dead group. In cardiogenic CPA, age was younger and creatinine level was lower in survival group compared with dead group (Table). In non-cardiogenic CPA, pupil diameter was smaller in survival group compared with dead group. Furthermore, in TP levels, the receiver operating characteristic (ROC) curve for survival after ROSC demonstrated that the area under curve (AUC) was 0.82 and provided an optimal cut-off value at 6.2 mg/dl of TP with 71% sensitivity and 83% specificity. In non-cardiogenic CPA, ROC curve demonstrated that AUC was 0.73 and 59% sensitivity, and 100% specificity at the optimal cut-off value of TP 6.0 mg/dl. Therefore, TP levels may be the better prognostic predictor in cardiogenic CPA compared with non-cardiogenic CPA. Conclusion: Although duration of CPA and TP levels were common predictor for survival after ROSC in CPA, there were different prognostic predictors in cardiogenic or non-cardiogenic CPA.