Reynolds Alexandra S, Matthews Elizabeth, Magid-Bernstein Jessica, Rodriguez Ashley, Park Soojin, Claassen Jan, Agarwal Sachin
Department of Neurology, Columbia University Medical Center, New York, NY, United States.
Department of Neurology, Columbia University Medical Center, New York, NY, United States.
Resuscitation. 2017 Apr;113:124-127. doi: 10.1016/j.resuscitation.2016.12.018. Epub 2017 Jan 3.
Neurological emergencies can lead to cardiac arrest, and post-arrest patients can develop life-threatening neurological abnormalities. This study aims to estimate and characterize the use of early head CT (HCT), and its potential impact on post-resuscitation management.
This retrospective study analyzed 213 adults who suffered an out-of-hospital cardiac arrest (OHCA) and survived for at least 24h. Demographics were collected and arrest-related variables were documented. Timing of HCT was recorded and if abnormalities were found on HCT within 24h of resuscitation, any resulting changes in management were recorded. Outcome was measured by cerebral performance category at discharge.
Only 54% of patients who survived OHCA underwent HCT in the first 24h after resuscitation. Patients who underwent HCT were healthier and had better pre-arrest functional status and shorter duration of arrest. Acute abnormalities were found on 38% of HCT and 34% of these abnormal scans resulted in management changes.
Early HCT is not consistently performed after OHCA and may be heavily influenced by a patient's premorbid status and duration of arrest. Early HCT can demonstrate acute abnormalities that can result in significant changes in patient management.
神经系统急症可导致心脏骤停，而心脏骤停复苏后的患者可能会出现危及生命的神经功能异常。本研究旨在评估和描述早期头颅CT（HCT）的使用情况及其对复苏后管理的潜在影响。
这项回顾性研究分析了213例院外心脏骤停（OHCA）且存活至少24小时的成年人。收集了人口统计学数据并记录了与心脏骤停相关的变量。记录HCT的检查时间，如果在复苏后24小时内HCT发现异常，则记录由此导致的任何管理变化。出院时通过脑功能分类来衡量结局。
在OHCA存活的患者中，只有54%在复苏后的头24小时内接受了HCT检查。接受HCT检查的患者身体状况较好，心脏骤停前功能状态更佳，且心脏骤停持续时间较短。38%的HCT检查发现了急性异常，其中34%的异常扫描结果导致了管理上的改变。
OHCA后早期HCT检查并未得到一致实施，可能受到患者病前状态和心脏骤停持续时间的严重影响。早期HCT检查可显示急性异常，从而导致患者管理发生重大变化。
