Neurological Outcomes After In-Hospital Cardiac Arrest

Neurological Outcomes After In-hospital Cardiac Arrest: a Prospective Observational Study

Little is known about the long-term neurological outcomes after in-hospital cardiac arrest (IHCA). It is also not known whether withdrawal of life-sustaining measures will influence rates of survivors with poor neurological status. Currently, withdrawal of care in comatose patients after cardiac arrest is strongly forbidden by law in Korea. However, a new legislation on allowing withdrawal of care will come into effect since early 2018 in Korea. The investigators aim to determine 1) long-term neurological outcomes in patients who developed IHCA, 2) whether early neurological status can predict late neurological status after IHCA, and 3) whether the proportion of IHCA survivors with good neurological outcomes will change since implementation of new legislation on withdrawal of care.

<The schedule of assessment>

• Day 0: Neurological examination (First examination will be performed within 2 hours after IHCA)
• Day1 - 7: Neurological examination
• Day7, 14, 21, 28: Neurological examination, CPC score
• Day90: CPC score, survival
• Day180: CPC score, survival
• Day 360: CPC score, survival

<Cerebral Performance Category(CPC) score>

• CPC 1: good cerebral performance
• CPC 2: Moderate cerebral disability(available for independent activities)
• CPC 3: Severe cerebral disability(dependent on others for daily support)
• CPC 4: Coma or vegetative state
• CPC 5: Brain death or death

<Acronyms>

• ACDU(Alert/Confused/Drowsy/Unresponsive) score
• FOUR(Full Outline of Unresponsiveness) score

Inclusion Criteria:

• Age ≥ 18
• In-hospital cardiac arrest
• Cardiopulmonary Resuscitation(CPR) code activation and/or neurology consultation for IHCA

Exclusion Criteria:

• Neither (CPR) code activation nor neurology consultation
• Development of IHCA during transition period