Outcome of comatose patients following cardiac arrest: When mRS completes CPC.
In: Resuscitation, Jg. 192 (2023-11-01), S. 109997
academicJournal
Zugriff:
Aim: Good outcome in patients following cardiac arrest (CA) is usually defined as Cerebral Performance Category (CPC) 1-2, while CPC 3 is debated, and CPC 4-5 represent poor outcome. We aimed to assess when the modified Rankin Scale (mRS) can improve CPC outcome description, especially in CPC 3. We further aimed to correlate neuron specific enolase (NSE) with both functional measures to explore their relationship with neuronal damage.
Methods: Peak NSE within the first 48 hours, and CPC and mRS at 3 months were prospectively collected for 665 consecutive comatose adults following CA treated between April 2016 and April 2023. For each CPC category, mRS was described. We considered good outcome as mRS 1-3, in line with existing recommendations. CPC and mRS were correlated to peak serum NSE using non-parametric assessments.
Results: CPC 1, 2, 4 and 5 correlated almost perfectly with mRS in terms of good and poor outcomes. However, CPC 3 was heterogeneously associated to the dichotomized mRS (53.1% had good outcome (mRS 0-3), 46.9% poor outcome (mRS 4-6)). NSE was strongly correlated with CPC (Spearman's rho 0.616, P < 0.001) and mRS (Spearman's rho 0.613, P < 0.001).
Conclusion: CPC and mRS correlate similarly with neuronal damage. Whilst CPC 1-2 and CPC 4-5 are strongly associated with mRS 0-3 and, respectively, with mRS 5-6, CPC 3 is heterogenous: both good and poor mRS scores are found within this category. Therefore, we suggest that the mRS should be routinely assessed in patients with CPC 3 to refine outcome description.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
| Titel: |
Outcome of comatose patients following cardiac arrest: When mRS completes CPC.
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| Autor/in / Beteiligte Person: | Tanaka Gutiez, M ; Beuchat, I ; Novy, J ; Ben-Hamouda, N ; Rossetti, AO |
| Zeitschrift: | Resuscitation, Jg. 192 (2023-11-01), S. 109997 |
| Veröffentlichung: | Limerick : Elsevier/north-Holland Biomedical Press ; <i>Original Publication</i>: London, Middlesex Pub. Co., 2023 |
| Medientyp: | academicJournal |
| ISSN: | 1873-1570 (electronic) |
| DOI: | 10.1016/j.resuscitation.2023.109997 |
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