Prognostic factors after cardiac arrest. Usefulness of early video-electroencephalogram ☆

Abstract Background and objective Predictors of unfavourable outcome in patients after cardiopulmonary arrest (CPA) are important to make decisions about the limitation of therapeutic efforts. The aim was to analyse the clinical variables in the prognosis of patients recovered after CPA. Material and method Retrospective study on comatose patients with recovered CPA. The variables were: age, sex, Glasgow Coma Score (GCS), pupillary light reflex, other variables related to CPA (cause, duration, witnessed or not witnessed), myoclonic status and electroencephalographic (EEG) patterns. Results Fifty patients were studied. The variables associated with mortality were the absence of pupillary light reflex (hazard ratio [HR] 0.277, 95% confidence interval [95% CI] 0.103–0.741, P  = .01), a low GCS (HR 0.701, 95% CI 0.542–0.908, P  = .007) and myoclonic state (HR 0.38, 95% CI 0.176–0.854, P  = .01). We evaluated the EEG patterns in 22 patients. No statistical significance was observed. Conclusions The absence of pupillary light reflex, a low GCS and myoclonic state are prognostic factors in patients recovered after a CPA. The EEG patterns showed a nonsignificant association with prognosis.