• Toshikazu Abe, Yasuharu Tokuda, Shinichi Ishimatsu, and SOS-KANTO study group.
• Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-city, Tokyo 104-8560, Japan. mican-philia@sunny.ocn.ne.jp
• Resuscitation. 2009 Apr 1; 80 (4): 431-6.

BackgroundComplete neurological recovery is of great importance to survivors of cardiac arrest. Few studies have explored predictors of good cerebral performance outcomes among these.MethodsWe analyzed data from the SOS-KANTO study, a prospective, multi-center, observational study on patients who had out-of-hospital cardiac arrest. We included patients with Glasgow-Pittsburgh cerebral performance categories (GP-CPC) 1 (good cerebral performance) and 2 (moderate cerebral disability) at 30 days after cardiac arrest.ResultsAmong 122 eligible patients, 85 (70%) with GP-CPC 1 and 37 (30%) with GP-CPC 2 outcomes were analyzed. More patients with GP-CPC 1 outcome (27%) received conventional cardiopulmonary resuscitation (CPR) than those with GP-CPC 2 outcome (5%). Proportions for receiving cardiac-only resuscitation were not different between the two groups. Based on a multiple logistic-regression model constructed using age and significant variables from bivariate analyses, significant factors for GP-CPC 1 outcome included: conventional bystander CPR compared to no bystander resuscitation with an odds ratio of 5.7 (95% CI, 1.1-30.4); positive pupillary reflex at the time of ED arrival with an odds ratio of 13.7 (95% CI, 3.5-53.7); spontaneous respiration at ED arrival with an odds ratio of 5.98 (95% CI, 1.6-23.0); and cardiac cause of initial arrest with an odds ratio of 5.9 (95% CI, 1.4-25.0).ConclusionsSurvivors of out-of-hospital cardiac arrest with recovery to good cerebral performance were more likely to have cardiac cause of arrest and show positive pupillary reflex and spontaneous respiration at ED arrival.

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