Kazumi Kumagai1, Yasutaka Oda2, Chiyomi Oshima1, Tadashi Kaneko1, Kotaro Kaneda1, Yoshikatsu Kawamura1, Yasuaki Ogino1, Susumu Yamashita3, Kiyoshi Ichihara4, Tsuyoshi Maekawa1,2, Ryosuke Tsuruta1,2. 1. Advanced Medical Emergency and Critical Care Center Yamaguchi University Hospital Ube Yamaguchi Japan. 2. Department of Stress and Bio-response Medicine Yamaguchi University Graduate School of Medicine Ube Yamaguchi Japan. 3. Emergency and Critical Care Center Tokuyama Central Hospital Shunan Yamaguchi Japan. 4. Department of Clinical Laboratory Science Faculty of Health Sciences Yamaguchi University Graduate School of Medicine Ube Yamaguchi Japan.
Abstract
Aim: Early prediction of the neurological outcomes of patients with out-of-hospital cardiac arrest is important to select the optimal clinical management. We hypothesized that clinical data recorded at the site of cardiopulmonary resuscitation would be clinically useful. Methods: This retrospective cohort study included patients with return of spontaneous circulation after cardiopulmonary resuscitation who were admitted to our university hospital between January 2000 and November 2013 or two affiliated hospitals between January 2006 and November 2013. Clinical parameters recorded on arrival included age (A), arterial blood pH (B), time from cardiopulmonary resuscitation to return of spontaneous circulation (C), pupil diameter (D), and initial rhythm (E). Glasgow Outcome Scale was recorded at 6 months and a favorable neurological outcome was defined as a score of 4-5 on the Glasgow Outcome Scale. Multiple logistic regression analysis was carried out to derive a formula to predict neurological outcomes based on basic clinical parameters. Results: The regression equation was derived using a teaching dataset (total, n = 477; favourable outcome, n = 55): EP = 1/(1 + e-x ), where EP is the estimated probability of having a favorable outcome, and x = (-0.023 × A) + (3.296 × B) - (0.070 × C) - (1.006 × D) + (2.426 × E) - 19.489. The sensitivity, specificity, and accuracy were 80%, 92%, and 90%, respectively, for the validation dataset (total, n = 201; favourable outcome, n = 25). Conclusion: The 6-month neurological outcomes can be predicted in patients resuscitated from out-of-hospital cardiac arrest using clinical parameters that can be easily recorded at the site of cardiopulmonary resuscitation.
Aim: Early prediction of the neurological outcomes of patients with out-of-hospital cardiac arrest is important to select the optimal clinical management. We hypothesized that clinical data recorded at the site of cardiopulmonary resuscitation would be clinically useful. Methods: This retrospective cohort study included patients with return of spontaneous circulation after cardiopulmonary resuscitation who were admitted to our university hospital between January 2000 and November 2013 or two affiliated hospitals between January 2006 and November 2013. Clinical parameters recorded on arrival included age (A), arterial blood pH (B), time from cardiopulmonary resuscitation to return of spontaneous circulation (C), pupil diameter (D), and initial rhythm (E). Glasgow Outcome Scale was recorded at 6 months and a favorable neurological outcome was defined as a score of 4-5 on the Glasgow Outcome Scale. Multiple logistic regression analysis was carried out to derive a formula to predict neurological outcomes based on basic clinical parameters. Results: The regression equation was derived using a teaching dataset (total, n = 477; favourable outcome, n = 55): EP = 1/(1 + e-x ), where EP is the estimated probability of having a favorable outcome, and x = (-0.023 × A) + (3.296 × B) - (0.070 × C) - (1.006 × D) + (2.426 × E) - 19.489. The sensitivity, specificity, and accuracy were 80%, 92%, and 90%, respectively, for the validation dataset (total, n = 201; favourable outcome, n = 25). Conclusion: The 6-month neurological outcomes can be predicted in patients resuscitated from out-of-hospital cardiac arrest using clinical parameters that can be easily recorded at the site of cardiopulmonary resuscitation.
Authors: Mary Ann Peberdy; Clifton W Callaway; Robert W Neumar; Romergryko G Geocadin; Janice L Zimmerman; Michael Donnino; Andrea Gabrielli; Scott M Silvers; Arno L Zaritsky; Raina Merchant; Terry L Vanden Hoek; Steven L Kronick Journal: Circulation Date: 2010-11-02 Impact factor: 29.690
Authors: D L Tirschwell; W T Longstreth; M E Rauch-Matthews; W L Chandler; T Rothstein; L Wray; L J Eng; J Fine; M K Copass Journal: Neurology Date: 1997-02 Impact factor: 9.910
Authors: Wan Young Heo; Yong Hun Jung; Hyoung Youn Lee; Kyung Woon Jeung; Byung Kook Lee; Chun Song Youn; Seung Pill Choi; Kyu Nam Park; Yong Il Min Journal: PLoS One Date: 2022-04-01 Impact factor: 3.240