Wu Wen, Chopra Amit, Ziegler Carolyn, McLeod Shelley L, Lin Steve
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Resuscitation. 2020 Jun;151:139-144. doi: 10.1016/j.resuscitation.2020.04.013. Epub 2020 Apr 15.
Neurological status following out-of-hospital cardiac arrest is commonly assessed using measures such as the Cerebral Performance Category (CPC) at hospital discharge. However, it remains unclear if these measures accurately reflect long-term neurological status after discharge. The objective of this systematic review was to determine the association between post-arrest neurological outcome scores at hospital discharge and long-term (>6 months) neurological outcome scores.
Comprehensive database searches of Medline, Embase, and the Cochrane library databases from inception to August 2019 were conducted and reference lists were hand-searched. Randomized controlled trials (RCT) and prospective observational studies were included.
After screening 7844 titles and abstracts independently and in duplicate, we included 7 studies with a total of 602 patients from 6 prospective observational studies and 1 RCT. Four studies reported long-term follow-up at 6 months post-arrest and three studies reported follow-up at 1 year. In the studies with 6-month follow-up, 368 patients (82.7%) had favorable short-term neurological scores (CPC 1-2) at discharge or 30 days post-arrest, and 352 patients (79.1%) had favorable scores at 6 months post-arrest. In the studies with 1-year follow-up, 101 patients (64.3%) had favorable neurological scores at discharge or 30 days post-arrest, and 91 patients (59.5%) patients had favorable neurological scores at 1 year.
Long-term neurological outcome scores following OHCA were consistent with short-term outcome at hospital discharge or 30 days post-arrest. All included studies measured neurological outcome using CPC, further studies are needed using other standards to better elucidate patient-centered long-term neurological outcome.
院外心脏骤停后的神经功能状态通常在出院时使用诸如脑功能分级（CPC）等指标进行评估。然而，这些指标是否能准确反映出院后的长期神经功能状态仍不清楚。本系统评价的目的是确定出院时心脏骤停后神经功能结局评分与长期（>6个月）神经功能结局评分之间的关联。
对Medline、Embase和Cochrane图书馆数据库从创建到2019年8月进行全面检索，并手工检索参考文献列表。纳入随机对照试验（RCT）和前瞻性观察性研究。
在独立且重复筛选7844篇标题和摘要后，我们纳入了7项研究，共602例患者，来自6项前瞻性观察性研究和1项RCT。4项研究报告了心脏骤停后6个月的长期随访，3项研究报告了1年的随访。在6个月随访的研究中，368例患者（82.7%）在出院时或心脏骤停后30天有良好的短期神经功能评分（CPC 1-2），352例患者（79.1%）在心脏骤停后6个月有良好的评分。在1年随访的研究中，101例患者（64.3%）在出院时或心脏骤停后30天有良好的神经功能评分，91例患者（59.5%）在1年时有良好的神经功能评分。
院外心脏骤停后的长期神经功能结局评分与出院时或心脏骤停后30天的短期结局一致。所有纳入研究均使用CPC测量神经功能结局，需要进一步使用其他标准进行研究，以更好地阐明以患者为中心的长期神经功能结局。
