Neurologic Recovery After Out-of-Hospital Cardiac Arrest

  1. W.T. LONGSTRETH, Jr., M.D., M.P.H.;
  2. THOMAS S. INUI, SC.M., M.D.;
  3. LEONARD A. COBB, M.D.; and
  4. MICHAEL K. COPASS, M.D.
  1. Seattle, Washington

    Abstract

    A retrospective cohort study of the neurologic sequelae of out-of-hospital cardiac arrest was done using 459 consecutive patients resuscitated and admitted to a teaching hospital over 10 years. Awakening was defined as having comprehensible speech or following commands. One hundred and eighty patients (39%) never awakened and 279 (61%) awakened, 188 without and 91 with persistent neurologic deficits. Fifty-nine patients had cognitive deficits and 32 patients had motor and cognitive deficits. Patients who did not awaken died, with a median survival of 3.5 days. The longer a patient survived without awakening, the smaller the probability of ever awakening and awakening without deficits. Fourteen patients awakening after 4 days had some deficits, and after 14 days six had severe deficits. Neurologic sequelae of cardiac arrest are common and related to awakening. The probability of future awakening and neurologic sequelae for patients not awake at specific times after cardiac arrest can be estimated.

    Article and Author Information

    • ▸From the Divisions of Neurology and Cardiology, Harborview Medical Center, the University of Washington School of Medicine; Seattle, Washington.

    • Grant support: in part by grants R18-HS-01943 from the National Center for Health Services Research, and HL-18805 from the National Heart Lung and Blood Institute. Dr. Longstreth was a fellow in the Robert Wood Johnson Clinical Scholars Program while working on the study. The views and opinions presented in this paper are those of the authors and may not reflect those of the Robert Wood Johnson Foundation.

    • ▸Requests for reprints should be addressed to W.T. Longstreth, Jr., M.D.; Seattle Public Health Hospital, P.O. Box 3145, 1131 14th Avenue South; Seattle, WA 98114.

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