• Jonathan Gelber, Martha E Montgomery, and Amandeep Singh.
• Highland Hospital Department of Emergency Medicine, Alameda Health System, Oakland, CA USA; University of California San Francisco Department of Emergency Medicine, San Francisco, CA USA. Electronic address: jonathan.gelber@ucsf.edu.
• Am J Emerg Med. 2021 Mar 1; 41: 70-72.

AimIntracranial Hemorrhage (ICH) is an important cause of out-of-hospital cardiac arrest (OHCA), yet there are no United States (US), European, or Australian prospective studies examining its incidence in patients who sustained OHCA. This study aims to identify the incidence of ICH in US patients with OHCA who obtain return of spontaneous circulation (ROSC).MethodsWe prospectively analyzed consecutive patients with OHCA who achieved ROSC at a single US hospital over a 15-month period. Before beginning patient enrollment, we implemented a standardized emergency department order-set for the initial management for all patients with ROSC after OHCA. This order-set included a non-contrast head computed-tomography (NCH-CT) scan. Patient and cardiac arrest variables were recorded, as were NCH-CT findings.ResultsDuring the study period, 85 patients sustained an OHCA, achieved ROSC, survived to hospital admission, and underwent a NCH-CT. Three of these 85 patients had ICH (3.5%). Survival to discharge was seen in 23/82 (28.0%) patients without ICH and in 1/3 patients with ICH. Survival with good neurologic outcome was seen in 14/82 (17.1%) patients without ICH and in 0/3 patients with ICH. Patients with ICH tended to be older than patients without ICH.ConclusionsIn our US cohort, ICH was an uncommon finding in patients who sustained OHCA and survived to hospital admission, and no patients with ICH survived to discharge with good neurologic outcome. Additionally, the incidence of ICH was lower than reported in previous studies.Copyright © 2020 Elsevier Inc. All rights reserved.

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