Journal of Internal Medicine Concepts & Practice >

2022 , Vol. 17 >Issue 06: 447 - 452

DOI: https://doi.org/10.16138/j.1673-6087.2022.06.005

Original article

A retrospective study on prediction of neurological outcome in cardiac arrest patients of out-hospital

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  • Department of Emergency, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China

Received date: 2021-07-21

  Online published: 2023-02-27

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Abstract

Objective To investigate the predictive power of neurological examination results and serum neuron specific enolase(NSE) concentration for the neurological outcome of cardiac arrest patients. Methods All cardiac arrest patients were retrospectively analyzed. They were divided into good outcome group [cerebral performance category (CPC)≤2] and poor outcome group (CPC≥3) according to CPC scores on day 30. According to Glasgow coma scale (GCS), serum NSE concentration, pupil light reflex, eye opening score (eGCS), limb movement score (mGCS) and the sum of two (emGCS) were compared between two groups. Repeated measures were used to evaluate the correlation, and Logistic regression analysis was used to explore the univariate and multivariate predictors. Results The serum NSE concentration in poor outcome group was significantly higher than that in good outcome group (P<0.01). The change of mGCS (Δ mGCS) and emGCS (Δ emGCS) within first 3 days in good outcome group was significantly higher than that in poor outcome group (P<0.05). Repeated measures ANOVA showed eGCS, mGCS and emGCS were significantly correlated with CPC grades(P<0.001). The analysis of generalized linear mixed model showed there was a significant correlation between absent of pupillary light reflex and poor neurological outcome (P=0.002). The eGCS, mGCS and emGCS in first 3 days, and presence of pupil light reflex on the second and third day, Δ mGCS, Δ emGCS and serum NSE levels were univariate predictors (P<0.05). Male and mGCS on day 3 were multivariate predictors (P<0.05). Conclusions The combination of male and mGCS on the 3rd day could be used to predict the poor neurological outcome in cardiac arrest patients.

Key words： Cardiac arrest; Neurological examination; Neuron specific enolase; Prognosis; Neurological function

Cite this article

LI Yongde, WANG Yang, LI Xiang, LI Wenjie, XIE Di, JIANG Shaowei, GE Xiaoli, WANG Hairong, GAO Chengjin, PAN Shuming . A retrospective study on prediction of neurological outcome in cardiac arrest patients of out-hospital[J]. Journal of Internal Medicine Concepts & Practice, 2022 , 17(06) : 447 -452 . DOI: 10.16138/j.1673-6087.2022.06.005

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