| Predictors of poor neurologic outcome in patients undergoing therapeutic hypothermia after cardiac arrest. | |
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MedLine Citation:
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PMID: 20224485 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Therapeutic hypothermia (TH) has been shown to reduce the degree of anoxic brain injury, decrease mortality, and improve neurologic recovery in patients surviving cardiac arrest. However, there is a paucity of data on potential markers of neurologic outcome that physicians can use in this setting. METHODS: A retrospective medical records review of 41 consecutive survivors of cardiac arrest treated with TH (2004-08) was examined. RESULTS: Mean patient age was 66 years old. Most subjects had an out-of-hospital, witnessed cardiac arrest, and two-thirds had received bystander cardiopulmonary resuscitation (CPR). About half of the patients had nonventricular tachycardia/fibrillation (VT/VF) arrests. Fifty-nine percent (24 of 41 subjects) died or experienced severe neurologic impairment. By bivariate analysis, factors associated with a poor neurologic prognosis included: 1) a first rhythm at cardiac arrest other than VT/VF (P = 0.01); 2) the presence of acute kidney injury (AKI) in the intensive care unit (ICU) (P < 0.001); 3) any treated cardiac arrhythmia after admission (P = 0.05); and 4) a Glasgow Coma Score <8 determined 12 hours after rewarming (P < 0.001). Using multiple regression analysis, non-VT/VF arrest, AKI, and cardiac arrhythmia remained significant risk factors for poor neurologic recovery. The cumulative risk of death or poor neurologic outcome increased with the presence of two or more risk factors. CONCLUSION: Several simple, reproducible clinical markers can help predict neurologic recovery, during and after treatment, in patients managed with TH for cardiac arrest. |
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Authors:
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Vincent J Vanston; Mary Lawhon-Triano; Roger Getts; John Prior; Raymond A Smego |
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Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: Southern medical journal Volume: 103 ISSN: 1541-8243 ISO Abbreviation: South. Med. J. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-06-07 Completed Date: 2010-07-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0404522 Medline TA: South Med J Country: United States |
Other Details:
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Languages: eng Pagination: 301-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Palliative Medicine, Scranton Temple Residency Training Program, Mercy Hospital, The Commonwealth Medical College, Scranton, PA 18510, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Arrhythmias, Cardiac / complications Cardiopulmonary Resuscitation Female Glasgow Coma Scale Heart Arrest / complications*, therapy* Humans Hypothermia, Induced* Intensive Care Units Kidney Failure, Acute / complications Male Middle Aged Nervous System Diseases / diagnosis*, etiology* Retrospective Studies Risk Factors Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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