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Assessment of Neurological Prognosis in Comatose Survivors of Cardiac Arrest
Lancet 343:1055-1059, Edgren,E.,et al, 1994
See this aricle in Pubmed
Article Abstract
Glasgow and Glasgow-Pittsburgh coma scores and their constituent signs were recorded at fixed times.Outcome was taken to be the best cerebral performance at any time during follow-up,and for that purpose we used cerebral performance categories(CPC 1-5)of the Glasgow outcome categories. A poor outcome(CPC 3-5)could be predicted immediately after reperfusion(at entry into the study)with an accuracy ranging from 52%to 84%for various signs and scores.On the third day it was possible to identify severely disabled or permanently comatose survivors without false predictions using both coma scores and several of their constituent variables.The best predictor was absence of motor response to pain.This modeling exercise now needs to be repeated on a new series of patients but the results do suggest that,after 3 days,stringent ethical criteria can be met and used in decision-making about termination of care in comatose cardiac arrest survivors.
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cardiac arrest
cardiac arrest and resuscitation
coma
coma,prognosis of
ethics in neurology
Glasgow coma score
hypoxic encephalopathy
life support,withdrawal of
neurologic examination
prognosis
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