Abstract Details

Title Ischemic stroke after targeted temperature management for out-of-hospital cardiac arrest: A MRI findings

Topic Neuro Trauma, Critical Care, and Sports Neurology

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

Poster/Presentation
Number 4-071

Objective We sought to determine characteristics and risk factors of ischemic stroke and whether stroke is a predictor of clinical outcome in out-of-hospital cardiac arrest (OHCA) patients who underwent targeted temperature management (TTM).

Background Patients treated with TTM for OHCA are at high risk of developing ischemic stroke. However, there is paucity of reports.

Design/Methods Consecutive OHCA patients treated with TTM in Severance hospital (Sep 2011 to Dec 2015), who underwent complete TTM were included. We assessed ischemic stroke based on brain MRI with diffusion weighted imaging (DWI), which was performed in the first week after return of spontaneous circulation (ROSC). Independent predictors for occurrence of stroke and good clinical outcome at discharge were determined using the logistic regression analyses. Age, sex, hypertension, diabetes and variables with p < 0.1 in univariate analyses were entered into each multivariate model.

Results Among 94 patients included in this study, we found 25 acute ischemic strokes. Nineteen patients had multiple scattered stroke lesions (76.0%), suggesting embolic origin. Patients with ischemic stroke were older (p < 0.001) and more frequently underwent major intervention (p = 0.006). Multivariate logistic regression revealed advancing age (OR 1.13, 95% CI: 1.06-1.20, p < 0.001) and major intervention (OR 9.13, 95% CI 1.90-43.91, p = 0.006) as risk factors for developing ischemic stroke. Hypoxic ischemic encephalopathy (HIE) (OR 0.02, p < 0.001) was an independent predictor of good clinical outcome at discharge compared to neither stroke nor HIE, however, ischemic stroke only was not (p = 0.468).

Conclusions

Ischemic stroke was found in quarter of the patients with TTM for OHCA when evaluated with MRI. Advancing age and history of major intervention were independent predictors of stroke occurrence. The effect of HIE overwhelms that of ischemic stroke to clinical outcome at discharge.

Authors/Disclosures
Minyoul Baik, Jr., MD (Department of Neurology, Yonsei University College of Medicine) PRESENTER	Dr. Baik has nothing to disclose.
	No disclosure on file
	No disclosure on file
Ji Hoe Heo, MD, PhD	No disclosure on file
Kyoo Ho Cho	No disclosure on file

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