Brain Recovery and Survival After Cardiac Arrest

TOPLINE:

Cardiac arrest survivors with complete neurologic recovery at hospital discharge show significantly improved long-term survival rates, found a study.

METHODOLOGY:

• Researchers analyzed data from four Swedish mandatory national registers between January 2010 and December 2019.
• This study included 9390 cardiac arrest survivors (median age, 69 years; 69.7% men) who survived at least 30 days after cardiac arrest.
• The primary outcome was the survival rate based on neurologic recovery at discharge, assessed using the Cerebral Performance Category (CPC) scale; on the basis of CPC scores, patients were grouped into those with complete recovery (CPC 1), those with moderate disabilities (CPC 2), and those with severe disabilities (CPC 3-4).

TAKEAWAY:

• At discharge, 78.5%, 14.5%, and 7.0% patients had a CPC score of 1, 2, and 3 or 4, respectively.
• At 5 years, survival rates were highest among patients with complete neurologic recovery (73.8%), followed by the CPC 2, (64.7%) and CPC 3-4 (54.2%) groups.
• The risk for death was 1.57 times and 2.46 times higher for those in the CPC 2 and CPC 3-4 groups, respectively, than for those in the CPC 1 group.
• The associations between neurologic recovery and long-term survival were similar across out-of-hospital and in-hospital cardiac arrest survivors.

IN PRACTICE:

“Complete neurologic recovery at hospital discharge among 30-day survivors after IHCA [in-hospital cardiac arrest] and OHCA [out-of-hospital cardiac arrest] was associated with better long-term survival compared with moderate or severe neurologic disabilities at the same time point,” the authors wrote. ” Our results further support the importance of postresuscitation care aiming to restore neurologic function, as this potentially leads to extended years of life,” they added.

SOURCE:

The study was led by Emelie Dillenbeck, MD, Center for Resuscitation Science, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden, and was published online on October 11, 2024, in JAMA Network Open.

LIMITATIONS:

The observational design of the study included unmeasured variables that could have influenced the interpretation of the results. In addition, the length of the follow-up period varied, which affected the generalizability of the findings. More than 2600 patients were excluded due to missing CPC scores at discharge, which may have introduced a bias. CPC scores were based on hospital records and were determined by different individuals, which could have affected the accuracy of the results.

DISCLOSURES:

The study was funded by a grant from Region Stockholm. One author reported serving as a leader in PARQ-COST, funded by the European Union. Another author reported receiving grants from the Swedish Heart Lung Foundation and Region Stockholm during the study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.