Serial characterization of neurological function after out-of-hospital cardiopulmonary arrest: incidence, prevalence, and predictors of late-improvement

Abstract

Purpose: Optimal times for follow-up after cardiac arrest have yet to be established in patients with out-of-hospital cardiopulmonary arrest (OHCA). This study was conducted to characterize neurological function serially after OHCA. Methods: The Japan-Prediction of neurological Outcomes in patients Post cardiac arrest (J-POP) registry is a prospective, multicenter, cohort study to test whether regional cerebral oxygen saturation (rSO2) predicts neurological outcomes after non-traumatic OHCA. We measured rSO2 in OHCA patients immediately after hospital arrival using a near-infrared spectrometer placed on the forehead. Primary endpoints are the Cerebral Performance Category (CPC; ranging from 1 [good cerebral performance/normal life] to 5 [brain death]) at 30 and 90 days after OHCA. Results: Since Japanese emergency medical service providers are not permitted to terminate resuscitation in the field, most patients with OHCA are transported to emergency hospitals. During the 15 months of the study, 1327 consecutive patients were studied, 1309 of whom were examined at 30 and 90 days after OHCA. Of 21 patients with CPC3 at 30 days, we found neurological status improvement in five patients (24%) at 90 days, who were younger than patients without neurological status improvement. However there was not difference in other patients' characteristics and rSO2 at hospital arrival between two groups (See Figure). ![Figure][1] Serial neurological function after OHCA Conclusions: Of patients with moderate neurological deficit at 30 days, we found neurological status improvement at 90 days in 24%. Patients' age was significant predictor for late-improvement of neurological function, however there was not difference in other patients characteristics and cerebral circumstances at hospital arrival between with or without late-improvement of neurological function. [1]: pending:yes