Predictors for good cerebral performance among adult survivors of out-of-hospital cardiac arrest

Abstract

Background Complete neurological recovery is of great importance to survivors of cardiac arrest. Few studies have explored predictors of good cerebral performance outcomes among these. Methods We analyzed data from the SOS-KANTO study, a prospective, multi-center, observational study on patients who had out-of-hospital cardiac arrest. We included patients with Glasgow-Pittsburgh cerebral performance categories (GP-CPC) 1 (good cerebral performance) and 2 (moderate cerebral disability) at 30 days after cardiac arrest. Results Among 122 eligible patients, 85 (70%) with GP-CPC 1 and 37 (30%) with GP-CPC 2 outcomes were analyzed. More patients with GP-CPC 1 outcome (27%) received conventional cardiopulmonary resuscitation (CPR) than those with GP-CPC 2 outcome (5%). Proportions for receiving cardiac-only resuscitation were not different between the two groups. Based on a multiple logistic-regression model constructed using age and significant variables from bivariate analyses, significant factors for GP-CPC 1 outcome included: conventional bystander CPR compared to no bystander resuscitation with an odds ratio of 5.7 (95% CI, 1.1–30.4); positive pupillary reflex at the time of ED arrival with an odds ratio of 13.7 (95% CI, 3.5–53.7); spontaneous respiration at ED arrival with an odds ratio of 5.98 (95% CI, 1.6–23.0); and cardiac cause of initial arrest with an odds ratio of 5.9 (95% CI, 1.4–25.0). Conclusions Survivors of out-of-hospital cardiac arrest with recovery to good cerebral performance were more likely to have cardiac cause of arrest and show positive pupillary reflex and spontaneous respiration at ED arrival.