Use of early head CT following out-of-hospital cardiopulmonary arrest

Resuscitation. 2017 Apr:113:124-127. doi: 10.1016/j.resuscitation.2016.12.018. Epub 2017 Jan 3.

Abstract

Aim: Neurological emergencies can lead to cardiac arrest, and post-arrest patients can develop life-threatening neurological abnormalities. This study aims to estimate and characterize the use of early head CT (HCT), and its potential impact on post-resuscitation management.

Methods: This retrospective study analyzed 213 adults who suffered an out-of-hospital cardiac arrest (OHCA) and survived for at least 24h. Demographics were collected and arrest-related variables were documented. Timing of HCT was recorded and if abnormalities were found on HCT within 24h of resuscitation, any resulting changes in management were recorded. Outcome was measured by cerebral performance category at discharge.

Results: Only 54% of patients who survived OHCA underwent HCT in the first 24h after resuscitation. Patients who underwent HCT were healthier and had better pre-arrest functional status and shorter duration of arrest. Acute abnormalities were found on 38% of HCT and 34% of these abnormal scans resulted in management changes.

Conclusions: Early HCT is not consistently performed after OHCA and may be heavily influenced by a patient's premorbid status and duration of arrest. Early HCT can demonstrate acute abnormalities that can result in significant changes in patient management.

Keywords: Head CT; Imaging; Out-of-hospital cardiac arrest.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aftercare / organization & administration
  • Aged
  • Brain / diagnostic imaging*
  • Cardiopulmonary Resuscitation* / adverse effects
  • Cardiopulmonary Resuscitation* / methods
  • Early Diagnosis*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nervous System Diseases* / complications
  • Nervous System Diseases* / diagnosis
  • Nervous System Diseases* / therapy
  • Out-of-Hospital Cardiac Arrest* / epidemiology
  • Out-of-Hospital Cardiac Arrest* / etiology
  • Out-of-Hospital Cardiac Arrest* / therapy
  • Patient Care Planning / organization & administration
  • Patient Discharge
  • Retrospective Studies
  • Time-to-Treatment
  • Tomography, X-Ray Computed / methods*
  • United States / epidemiology