Abstract Details

Title Functional Outcome of Post Cardiac Arrest Patients Who Underwent Therapeutic Hypothermia

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) P16 - Poster Session 16 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-014

Objective To evaluate functional outcome at time of discharge in patients who underwent therapeutic hypothermia (TH) after cardiac arrest.

Background TH is recommended for patients who suffered cardiac arrest and has been shown to improve neurologic outcome. We previously reported that the negative predictive value (NPV) for absence of four brain stem reflexes combined (doll’s eye, corneal reflex, pupillary reflex and gag) is 97%. We updated our cohort with an additional 31 patients and evaluated all patients with the cerebral performance category (CPC) score.

Design/Methods Retrospective chart review of patients who underwent TH at a tertiary care hospital in Newark, NJ from August 2012 to September 2019. The CPC score is used to grade neurologic outcomes after cardiac arrest. The scale ranges from 1 to 5. Higher scores represent greater disability. A score of 1 (minor disability) or 2 (moderate disability) represents a favorable outcome. A score of 3 (severe disability) or 4 (vegetative state or coma) represents poor outcome. A score of 5 is death.

Results 129 patients were analyzed (57% men and 43% women, mean age 56±15). Two-thirds of all patients who underwent TH protocol died and one-third of all patients survived. Two-thirds of patients had one to four of the aforementioned brainstem reflexes on initial exam and one-third had absence of all four brainstem reflexes. 96% of patients with absence of all four brainstem reflexes died, and 4% survived with a CPC score of 4. Of the patients with one to four brainstem reflexes present, 52% survived. Of those, two-thirds had a CPC score of 1 or 2 and one-third had a CPC score of 3 or 4 at time of discharge.

Conclusions The NPV for survival with absence of four brainstem reflexes on initial exam is 96%. Of the entire cohort, 22% had a favorable outcome (CPC 1 or 2).

Authors/Disclosures
Julian Agin-Liebes, MD (Columbia University Medical Center) PRESENTER	Dr. Agin-Liebes has nothing to disclose.
Toluwalase O. Tofade, MBBS (Medstar)	Dr. Tofade has nothing to disclose.
Rajanigandhi Hanumanthu, MD	No disclosure on file
Machteld E. Hillen, MD, FAAN (Rutgers-NJMS)	The institution of Dr. Hillen has received research support from Genentech.

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