The Role of Brain CT in Patients with Out-of-Hospital Cardiac Arrest with Return of Spontaneous Circulation.

Abstract

The diagnosis and treatment process after resuscitation of patients with spontaneous return of circulation (ROSC) after cardiac arrest is important. There is no clear recommendation on utilization of computerized tomography (CT) of the brain in patients with ROSC. In this study, it was aimed to diagnosis the pathology detection rates in the brain tomography of out-of-hospital cardiac arrest (OHCA) patients with ROSC after resuscitation in the emergency department and the effect of these pathologies on treatment management. 131 patients who were admitted to the Emergency Medicine Clinic with cardiac arrest between 08.05.2019 and 07.12.2020, had ROSC after resuscitation and underwent brain CT in the first 24h were included in the study. The patients were divided into two groups; those with clinically significant pathology in brain CT who underwent treatment changes and those without clinically significant pathology. All data recorded in the study form were analyzed using IBM SPSS 20.0 (Chicago, IL, USA) statistics program. P<0.005 value was considered statistically significant. 51.1% (67) of the patients were women. The age median value was 73 (IQR25-IQR75;63-83). The most common comorbidity in patients was hypertension with 42% (55). Patients with clinically significant pathology observed in brain tomography studied after ROSC were 12.2% (16) of all patients. The most common management changes were requesting a consultation from the neurology department (n=9) and adding a new drug to the treatment (n= 5) The 30-day and 1-year mortality rates showed no significant difference between the two groups (p>0.05). We have seen that the data obtained from the CT studied in the early period after the ROSC was achieved, did not change the management of our patients x in the early and late periods after resuscitation. We conclude that it is not necessary to have a brain CT scan in the emergency department in the early period.