Şahutoğlu Cengiz, Uyar Mehmet, Demirağ Kubilay, İsayev Hasan, Moral Ali Reşat
Department of Anaesthesiology and Reanimation, Ege University School of Medicine, İzmir, Turkey.
Department of Radiology, Ege University School of Medicine, İzmir, Turkey.
Turk J Anaesthesiol Reanim. 2016 Dec;44(6):295-300. doi: 10.5152/TJAR.2016.38802. Epub 2016 Dec 1.
There are several prediction scales and parameters for prognosis after a cardiac arrest. One of these scales is the brain arrest neurological outcome scale (BrANOS), which consists of duration of cardiac arrest, Glasgow Coma Scale score and Hounsfield unit measured on cranial computed tomography (CT) scan. The objective of this study is to investigate the effectiveness of BrANOS on predicting the mortality and disability after a cardiac arrest.
We retrospectively investigated cardiac arrest patients who were hospitalized in our intensive care unit (ICU) within a 3-year period. Inclusion criteria were age over 18 years old, survival of more than 24 hours after cardiac arrest and availability of cranial CT. We recorded the age, sex, diagnosis, duration of cardiac arrest and hospital stay, mortality, Glasgow Outcome Score (GOS) and BrANOS score. The primary endpoint of the study was to establish the relationship between mortality and BrANOS score in patients who survived for more than 24 hours after a cardiac arrest. The secondary endpoint of the study was to determine the 2-year life expectancy and GOS after cardiac arrest.
The mean age of the patients was 57±17 years (33 females, 67 males). ICU mortality rate was 57%. The BrANOS mean score was 10.3±3.2. There was a significant difference between survivors and non-survivors in terms of the BrANOS score (8.8±3.2 vs. 11.6±2.7; p<0.001). BrANOS reliably predicted the survival with a ROC area under the curve of 0.733. The scale of >14 predicted death with 100% accuracy. All the patients without disability had a BrANOS score of <10. The BrANOS score also correlated well with GOS (p<0.001). The 2-year life expectancy rate was 31% in patients who survived more than 24 hours after a cardiac arrest.
In this study, we demonstrated that BrANOS provided reliable data for prognostic evaluation after a cardiac arrest.
心脏骤停后有多种预后预测量表和参数。其中一种量表是脑骤停神经学预后量表（BrANOS），它由心脏骤停持续时间、格拉斯哥昏迷量表评分以及头颅计算机断层扫描（CT）测得的亨氏单位组成。本研究的目的是探讨BrANOS在预测心脏骤停后死亡率和残疾情况方面的有效性。
我们回顾性研究了在3年期间入住我们重症监护病房（ICU）的心脏骤停患者。纳入标准为年龄超过18岁、心脏骤停后存活超过24小时且有头颅CT检查结果。我们记录了年龄、性别、诊断、心脏骤停持续时间和住院时间、死亡率、格拉斯哥预后评分（GOS）和BrANOS评分。本研究的主要终点是确定心脏骤停后存活超过24小时的患者死亡率与BrANOS评分之间的关系。研究的次要终点是确定心脏骤停后的2年预期寿命和GOS。
患者的平均年龄为57±17岁（女性33例，男性67例）。ICU死亡率为57%。BrANOS平均评分为10.3±3.2。在BrANOS评分方面，存活者与非存活者之间存在显著差异（8.8±3.2对11.6±2.7；p<0.001）。BrANOS能可靠地预测存活情况，曲线下面积（ROC）为0.733。评分>14可100%准确预测死亡。所有无残疾的患者BrANOS评分均<10。BrANOS评分与GOS也具有良好的相关性（p<0.001）。心脏骤停后存活超过24小时的患者2年预期寿命率为31%。
在本研究中，我们证明了BrANOS为心脏骤停后的预后评估提供了可靠的数据。
