Regional cerebral oxygen saturation monitoring for predicting interventional outcomes in patients following out-of-hospital cardiac arrest of presumed cardiac cause: A prospective, observational, multicentre study

J-POP Registry Investigators

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Abstract

Aim: This study investigated the value of regional cerebral oxygen saturation (rSO2) monitoring upon arrival at the hospital for predicting post-cardiac arrest intervention outcomes. Methods: We enrolled 1195 patients with out-of-hospital cardiac arrest of presumed cardiac cause from the Japan-Prediction of Neurological Outcomes in Patients Post-cardiac Arrest Registry. The primary endpoint was a good neurologic outcome (cerebral performance categories 1 or 2 [CPC1/2]) 90 days post-event. Results: A total of 68 patients (6%) had good neurologic outcomes. We found a mean rSO2 of 21%±13%. A receiver operating characteristic curve analysis indicated an optimal rSO2 cut-off of ≥40% for good neurologic outcomes (area under the curve 0.92, sensitivity 0.81, specificity 0.96). Good neurologic outcomes were observed in 53% (55/103) and 1% (13/1092) of patients with high (≥40%) and low (<40%) rSO2, respectively. Even without return of spontaneous circulation (ROSC) upon arrival at the hospital, 30% (9/30) of patients with high rSO2 had good neurologic outcomes. Furthermore, 16 patients demonstrating ROSC upon arrival at the hospital and low rSO2 had poor neurologic outcomes. Multivariate analyses indicated that high rSO2 was independently associated with good neurologic outcomes (odds ratio=14.07, P<0.001). Patients with high rSO2 showed favourable neurologic prognoses if they had undergone therapeutic hypothermia or coronary angiography (CPC1/2, 69% [54/78]). However, 24% (25/103) of those with high rSO2 did not undergo these procedures and exhibited unfavourable neurologic prognoses (CPC1/2, 4% [1/25]). Conclusion: rSO2 is a good indicator of 90-day neurologic outcomes for post-cardiac arrest intervention patients.

Original languageEnglish
Pages (from-to)135-141
Number of pages7
JournalResuscitation
Volume96
DOIs
Publication statusPublished - 2015 Nov 1

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Out-of-Hospital Cardiac Arrest
Nervous System
Multicenter Studies
Observational Studies
Oxygen
Heart Arrest
Induced Hypothermia
Coronary Angiography
ROC Curve
Area Under Curve
Registries
Japan
Multivariate Analysis
Odds Ratio

Keywords

  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Cerebrovascular circulation
  • Oxygen
  • Prognoses

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this

@article{f615a6a86e3d4694928bc749b953828f,
title = "Regional cerebral oxygen saturation monitoring for predicting interventional outcomes in patients following out-of-hospital cardiac arrest of presumed cardiac cause: A prospective, observational, multicentre study",
abstract = "Aim: This study investigated the value of regional cerebral oxygen saturation (rSO2) monitoring upon arrival at the hospital for predicting post-cardiac arrest intervention outcomes. Methods: We enrolled 1195 patients with out-of-hospital cardiac arrest of presumed cardiac cause from the Japan-Prediction of Neurological Outcomes in Patients Post-cardiac Arrest Registry. The primary endpoint was a good neurologic outcome (cerebral performance categories 1 or 2 [CPC1/2]) 90 days post-event. Results: A total of 68 patients (6{\%}) had good neurologic outcomes. We found a mean rSO2 of 21{\%}±13{\%}. A receiver operating characteristic curve analysis indicated an optimal rSO2 cut-off of ≥40{\%} for good neurologic outcomes (area under the curve 0.92, sensitivity 0.81, specificity 0.96). Good neurologic outcomes were observed in 53{\%} (55/103) and 1{\%} (13/1092) of patients with high (≥40{\%}) and low (<40{\%}) rSO2, respectively. Even without return of spontaneous circulation (ROSC) upon arrival at the hospital, 30{\%} (9/30) of patients with high rSO2 had good neurologic outcomes. Furthermore, 16 patients demonstrating ROSC upon arrival at the hospital and low rSO2 had poor neurologic outcomes. Multivariate analyses indicated that high rSO2 was independently associated with good neurologic outcomes (odds ratio=14.07, P<0.001). Patients with high rSO2 showed favourable neurologic prognoses if they had undergone therapeutic hypothermia or coronary angiography (CPC1/2, 69{\%} [54/78]). However, 24{\%} (25/103) of those with high rSO2 did not undergo these procedures and exhibited unfavourable neurologic prognoses (CPC1/2, 4{\%} [1/25]). Conclusion: rSO2 is a good indicator of 90-day neurologic outcomes for post-cardiac arrest intervention patients.",
keywords = "Cardiac arrest, Cardiopulmonary resuscitation, Cerebrovascular circulation, Oxygen, Prognoses",
author = "{J-POP Registry Investigators} and Kei Nishiyama and Noritoshi Ito and Tomohiko Orita and Kei Hayashida and Hideki Arimoto and Satoru Beppu and Mitsuru Abe and Takashi Unoki and Tomoyuki Endo and Akira Murai and Takeshi Hatada and Noriaki Yamada and Masahiro Mizobuchi and Hideo Himeno and Kazuo Okuchi and Hideto Yasuda and Toshiaki Mochizuki and Kazuhiro Shiga and Migaku Kikuchi and Yuka Tsujimura and Tetsuo Hatanaka and Ken Nagao",
year = "2015",
month = "11",
day = "1",
doi = "10.1016/j.resuscitation.2015.07.049",
language = "English",
volume = "96",
pages = "135--141",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Regional cerebral oxygen saturation monitoring for predicting interventional outcomes in patients following out-of-hospital cardiac arrest of presumed cardiac cause

T2 - A prospective, observational, multicentre study

AU - J-POP Registry Investigators

AU - Nishiyama, Kei

AU - Ito, Noritoshi

AU - Orita, Tomohiko

AU - Hayashida, Kei

AU - Arimoto, Hideki

AU - Beppu, Satoru

AU - Abe, Mitsuru

AU - Unoki, Takashi

AU - Endo, Tomoyuki

AU - Murai, Akira

AU - Hatada, Takeshi

AU - Yamada, Noriaki

AU - Mizobuchi, Masahiro

AU - Himeno, Hideo

AU - Okuchi, Kazuo

AU - Yasuda, Hideto

AU - Mochizuki, Toshiaki

AU - Shiga, Kazuhiro

AU - Kikuchi, Migaku

AU - Tsujimura, Yuka

AU - Hatanaka, Tetsuo

AU - Nagao, Ken

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Aim: This study investigated the value of regional cerebral oxygen saturation (rSO2) monitoring upon arrival at the hospital for predicting post-cardiac arrest intervention outcomes. Methods: We enrolled 1195 patients with out-of-hospital cardiac arrest of presumed cardiac cause from the Japan-Prediction of Neurological Outcomes in Patients Post-cardiac Arrest Registry. The primary endpoint was a good neurologic outcome (cerebral performance categories 1 or 2 [CPC1/2]) 90 days post-event. Results: A total of 68 patients (6%) had good neurologic outcomes. We found a mean rSO2 of 21%±13%. A receiver operating characteristic curve analysis indicated an optimal rSO2 cut-off of ≥40% for good neurologic outcomes (area under the curve 0.92, sensitivity 0.81, specificity 0.96). Good neurologic outcomes were observed in 53% (55/103) and 1% (13/1092) of patients with high (≥40%) and low (<40%) rSO2, respectively. Even without return of spontaneous circulation (ROSC) upon arrival at the hospital, 30% (9/30) of patients with high rSO2 had good neurologic outcomes. Furthermore, 16 patients demonstrating ROSC upon arrival at the hospital and low rSO2 had poor neurologic outcomes. Multivariate analyses indicated that high rSO2 was independently associated with good neurologic outcomes (odds ratio=14.07, P<0.001). Patients with high rSO2 showed favourable neurologic prognoses if they had undergone therapeutic hypothermia or coronary angiography (CPC1/2, 69% [54/78]). However, 24% (25/103) of those with high rSO2 did not undergo these procedures and exhibited unfavourable neurologic prognoses (CPC1/2, 4% [1/25]). Conclusion: rSO2 is a good indicator of 90-day neurologic outcomes for post-cardiac arrest intervention patients.

AB - Aim: This study investigated the value of regional cerebral oxygen saturation (rSO2) monitoring upon arrival at the hospital for predicting post-cardiac arrest intervention outcomes. Methods: We enrolled 1195 patients with out-of-hospital cardiac arrest of presumed cardiac cause from the Japan-Prediction of Neurological Outcomes in Patients Post-cardiac Arrest Registry. The primary endpoint was a good neurologic outcome (cerebral performance categories 1 or 2 [CPC1/2]) 90 days post-event. Results: A total of 68 patients (6%) had good neurologic outcomes. We found a mean rSO2 of 21%±13%. A receiver operating characteristic curve analysis indicated an optimal rSO2 cut-off of ≥40% for good neurologic outcomes (area under the curve 0.92, sensitivity 0.81, specificity 0.96). Good neurologic outcomes were observed in 53% (55/103) and 1% (13/1092) of patients with high (≥40%) and low (<40%) rSO2, respectively. Even without return of spontaneous circulation (ROSC) upon arrival at the hospital, 30% (9/30) of patients with high rSO2 had good neurologic outcomes. Furthermore, 16 patients demonstrating ROSC upon arrival at the hospital and low rSO2 had poor neurologic outcomes. Multivariate analyses indicated that high rSO2 was independently associated with good neurologic outcomes (odds ratio=14.07, P<0.001). Patients with high rSO2 showed favourable neurologic prognoses if they had undergone therapeutic hypothermia or coronary angiography (CPC1/2, 69% [54/78]). However, 24% (25/103) of those with high rSO2 did not undergo these procedures and exhibited unfavourable neurologic prognoses (CPC1/2, 4% [1/25]). Conclusion: rSO2 is a good indicator of 90-day neurologic outcomes for post-cardiac arrest intervention patients.

KW - Cardiac arrest

KW - Cardiopulmonary resuscitation

KW - Cerebrovascular circulation

KW - Oxygen

KW - Prognoses

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U2 - 10.1016/j.resuscitation.2015.07.049

DO - 10.1016/j.resuscitation.2015.07.049

M3 - Article

C2 - 26291387

AN - SCOPUS:84944880038

VL - 96

SP - 135

EP - 141

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -