Abstract Details

Title Neurological Outcomes in Cardiac Arrest Patients with Non-shockable vs. Shockable Rhythm Treated With Targeted Temperature Management

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-065

Objective This study aims to identify early predictors of neurologic outcome in patients with non-shockable rhythm after cardiac arrest.

Background Cardiac arrest patients with non-shockable rhythm have significantly higher rates of poor outcome and different demographic characteristics compared to patients with shockable rhythm. Few studies have focused on outcome associations in non-shockable patients.

Design/Methods 172 non-shockable and 285 shockable rhythm patients where identified from the INTCAR TTM database. Data within the first 24 hours were collected. EEG patterns were categorized as malignant or non-malignant. CT scans were given a score of 0 (normal), 1 (one region with loss of grey/white differentiation), or 2 (two or more regions with loss of grey/white differentiation).

Results In non-shockable patients, good neurologic outcomes were associated with in-hospital cardiac arrests (50%) compared to Emergency Department (25%) or out-of-hospital arrests (13%). Clinical variables associated with good outcome for non-shockable patients included: in-hospital cardiac arrest (p < 0.001), short time to ROSC (p < 0.001), and short ET response time (p < 0.001) In those patients with EEG and CT data available in the first 24 hours: poor outcome was associated with early malignant EEG (p = 0.002) and abnormal CT grades (p = 0.004). In comparison to shockable patients, non-shockable patients were older and more often presented with comorbidities, shock on admission, malignant EEG patterns, abnormal CT grades, higher lactate levels, higher creatinine level, lower pH, and lower MAP.

Conclusions

We have identified several early associations with both good and poor outcome in the non-shockable group. CT and EEG were particularly high yield in the non-shockable group, with more than 1/3 of patients having abnormal studies that were highly specific for poor outcome. Our clinical profile of non-shockable cardiac arrest patients may assist with outcome prediction and future investigations to improve outcome.

Authors/Disclosures
Gopika Hari PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Pezhman Roohani, MD	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
James R. White, MD (Minnesota Epilepsy Group, PA)	No disclosure on file

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