Effect of Admission Glasgow Coma Scale Motor Score on Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Therapeutic Hypothermia

Toru Hifumi; Yasuhiro Kuroda; Kenya Kawakita; Hirotaka Sawano; Yoshio Tahara; Mamoru Hase; Kenji Nishioka; Shinichi Shirai; Hiroshi Hazui; Hideki Arimoto; Kazunori Kashiwase; Shunji Kasaoka; Tomokazu Motomura; Yuji Yasuga; Naohiro Yonemoto; Hiroyuki Yokoyama; Ken Nagao; Hiroshi Nonogi; the J-PULSE-Hypo Investigators

doi:10.1253/circj.CJ-15-0308

Critical Care

Effect of Admission Glasgow Coma Scale Motor Score on Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Therapeutic Hypothermia

Toru Hifumi, Yasuhiro Kuroda, Kenya Kawakita, Hirotaka Sawano, Yoshio Tahara, Mamoru Hase, Kenji Nishioka, Shinichi Shirai, Hiroshi Hazui, Hideki Arimoto, Kazunori Kashiwase, Shunji Kasaoka, Tomokazu Motomura, Yuji Yasuga, Naohiro Yonemoto, Hiroyuki Yokoyama, Ken Nagao, Hiroshi Nonogi, the J-PULSE-Hypo Investigators

Author information

Toru Hifumi
Emergency Medical Center, Kagawa University Hospital
Yasuhiro Kuroda
Emergency Medical Center, Kagawa University Hospital
Kenya Kawakita
Emergency Medical Center, Kagawa University Hospital
Hirotaka Sawano
Senri Critical Care Medical Center, Saiseikai Senri Hospital
Yoshio Tahara
Division of Cardiovascular Care Unit, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
Mamoru Hase
Department of Traumatology and Critical Care Medicine, Sapporo Medical University School of Medicine
Kenji Nishioka
Hiroshima City Hospital
Shinichi Shirai
Division of Cardiology, Kokura Memorial Hospital
Hiroshi Hazui
Emergency Medicine, Osaka Mishima Emergency and Critical Care Center
Hideki Arimoto
Emergency and Critical Care Medical Center, Osaka City General Hospital
Kazunori Kashiwase
Cardiovascular Division, Osaka Police Hospital
Shunji Kasaoka
Department of Emergency and General Medicine, Kumamoto University Hospital
Tomokazu Motomura
Shock & Trauma Center, Chiba Hokusoh Hospital, Nippon Medical School
Yuji Yasuga
Department of Cardiology, Sumitomo Hospital
Naohiro Yonemoto
Department of Psychopharmacology, National Center of Neurology and Psychiatry
Hiroyuki Yokoyama
Division of Cardiovascular Care Unit, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
Ken Nagao
Department of Cardiology, Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital
Hiroshi Nonogi
Shizuoka General Hospital
the J-PULSE-Hypo Investigators

Keywords: Cardiac arrest, Glasgow Coma Scale, Neurological examination, Therapeutic hypothermia

JOURNAL FREE ACCESS FULL-TEXT HTML

2015 Volume 79 Issue 10 Pages 2201-2208

DOI https://doi.org/10.1253/circj.CJ-15-0308

Browse “Advance online publication” version

Details

Abstract

Background:Because the initial (on admission) Glasgow Coma Scale (GCS) examination has not been fully evaluated in comatose survivors of cardiac arrest (CA) who receive therapeutic hypothermia (TH), the aim of the present study was to determine any association between the admission GCS motor score and neurologic outcomes in patients with out-of-hospital CA who receive TH.Methods and Results:In the J-PULSE-HYPO study registry, patients with bystander-witnessed CA were eligible for inclusion. Patients were divided into 3 groups based on GCS motor score (1, 2–3, and 4–5) to assess various effects on neurologic outcome. Univariate and multivariate analyses were performed to identify independent predictors of good neurologic outcome at 90 days. Of 452 patients, 302 were enrolled. There was a significant difference among the 3 patient groups with regard to neurologic outcome at 90 days in the univariate analysis. Multiple logistic regression analyses showed that the GCS motor score on admission, age >65 years, bystander cardiopulmonary resuscitation, the time from collapse to return of spontaneous circulation, and pupil size <4 mm were independent predictors of a good neurologic outcome at 90 days in cases of CA (GCS motor score, 4–5: odds ratio, 8.18; 95% confidence interval: 1.90–60.28; P<0.01).Conclusions:GCS motor score is an independent predictor of good neurologic outcome at 90 days in patients sustaining out-of-hospital CA who receive TH. (Circ J 2015; 79: 2201–2208)

Corresponding author

Register with J-STAGE for free!